Baseline CRP levels can predict cardiovascular events among health individuals

Baseline crp levels can predict cardiovascular events

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Baseline CRP levels can predict cardiovascular events among health individuals o Hyperhomocysteinemia o Homocysteine is derived from the metabolism of dietary methionine Methionine: an amino acid that is abundant in animal protein o Inhibits elements of the anticoagulant cascade & endothelial damage (1 st step in atherosclerosis) o Increased lipoprotein (a) levels o Lipoprotein (a) (Lp[a]): altered form of LDL that contains apoB-100 linked to apoA o Independent risk factor for the development of atherosclerosis o Enhances cholesterol delivery to injured blood vessels, suppresses generation of plasmin, promotes smooth muscle proliferation o Heritable & are not altered by most cholesterol-lowering drugs Pathogenesis & Mechanisms of Development o Fatty Streaks: thin yellow lines running along the major arteries, such as aorta. o Consists of smooth muscle cells filled with cholesterol & macrophages o Found in 10 to 14 y/o regardless of gender or race o Increase in # until 20 y/o o No symptoms o Overtime advanced form of atherosclerosis called atheroma or fibrous plaque o Fibrous atheromatous plaque: basic lesions of clinical atherosclerosis o Accumulation of intracellular & extracellular lipids, o proliferation of vascular smooth muscle cells o formation of scar tissue
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o calcification o gray to pearly white + thickening of vessel intima with a core of extracellular lipid covered by fibrous cap of connective tissue and smooth muscle o increase in size encroach on the lumen of the artery occlude vessel or predispose to thrombus formation= blood flow o Complicated atherosclerotic lesions o Develops when the fibrous plaque breaks open, producing hemorrhage, ulceration, scar tissue deposits. o Thrombosis – most important complication of atherosclerosis Caused by slowing & turbulence of blood flow in the region of the plaque & ulceration of the plaque Development of Lesions: 1. Injury to the endothelial vessel is the imitating factor 2. Possible injurious agents a. products associate with smoking, immune mechanisms, mechanical stress associated with HTN 3.Hemodynamic factors play a role: 4.Hyperlipidemia 5.Interaction between endothelial layer of the vessel wall & white blood cells
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  • Fall '15
  • Robert Mele
  • Atherosclerosis, ascending aorta, vessel wall, lower extremities

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