Pharmacotherapy of Acute Coronary Syndromes (ACS) Introduction

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What is the predominant cause of acute coronary syndromes?

Atherosclerotic plaque rupture

Which enzyme converts fibrinogen to fibrin in the coagulation cascade following plaque rupture?

Thrombin (factor IIa)

Which symptom is commonly associated with acute coronary syndromes?

Nausea or vomiting

What is the main characteristic of STE MI (Q-wave or transmural MI) on ECG?

<p>Pathologic Q waves</p> Signup and view all the answers

What is the characteristic ECG finding in NSTE MI (non–Q-wave or non-transmural MI)?

<p>No pathologic Q wave on ECG</p> Signup and view all the answers

What are the major lipids found in the body?

<p>Cholesterol, triglycerides, and phospholipids</p> Signup and view all the answers

Which lipoprotein carries 60% to 70% of the total serum cholesterol?

<p>LDL</p> Signup and view all the answers

What is the primary target of cholesterol-lowering therapy?

<p>LDL</p> Signup and view all the answers

Which class of lipoprotein is enriched with cholesterol esters and is smaller, denser, and more atherogenic than less dense VLDL?

<p>VLDL</p> Signup and view all the answers

What constitutes one of the two major risk factors for Coronary Heart Disease (CHD)?

<p>Abnormalities of plasma lipoproteins (LP)</p> Signup and view all the answers

Which lipoprotein carries about 10% to 15% of serum cholesterol and is a precursor for LDL?

<p>VLDL</p> Signup and view all the answers

Which lipoprotein is responsible for transporting fatty acids and cholesterol derived from the diet or synthesized in the intestines from the gut to the liver?

<p>Chylomicrons</p> Signup and view all the answers

Which apolipoprotein is a ligand for LDL receptors on the surface of hepatocytes and peripheral cells?

<p>Apolipoprotein E</p> Signup and view all the answers

Which lipoprotein plays a small role in the pathogenesis of atherosclerosis, is large, and transports cholesterol from peripheral cells back to the liver?

<p>HDL</p> Signup and view all the answers

Which lipoprotein particle contains apolipoproteins B-100, E, and C, and is formed in the liver?

<p>VLDL</p> Signup and view all the answers

Which class of lipoproteins is associated with abnormalities that can result in a predisposition to coronary, cerebrovascular, and peripheral vascular diseases?

<p>Low-density lipoproteins (LDL)</p> Signup and view all the answers

What is the primary target of cholesterol-lowering therapy?

<p>Low-density lipoproteins (LDL)</p> Signup and view all the answers

Which lipoprotein is enriched with cholesterol esters, smaller, denser, and more atherogenic than less dense VLDL?

<p>Low-density lipoproteins (LDL)</p> Signup and view all the answers

Which abnormality can be defined as an elevation in total cholesterol, elevation in LDL cholesterol, elevation in triglycerides, or low HDL cholesterol concentration?

<p>Dyslipidemia</p> Signup and view all the answers

Which lipoprotein carries about 10% to 15% of serum cholesterol and is a precursor for LDL?

<p>High-density lipoproteins (HDL)</p> Signup and view all the answers

What constitutes one of the two major risk factors for Coronary Heart Disease (CHD)?

<p>Low HDL cholesterol</p> Signup and view all the answers

What is the process called when HDL transports cholesterol from peripheral cells back to the liver?

<p>Reverse cholesterol transport</p> Signup and view all the answers

What kind of lipoprotein is enriched with cholesterol esters, smaller, denser, and more atherogenic than less dense VLDL?

<p>LDL</p> Signup and view all the answers

What is the primary target of cholesterol-lowering therapy?

<p>LDL</p> Signup and view all the answers

Which apolipoprotein is a ligand for LDL receptors on the surface of hepatocytes and peripheral cells?

<p>B-100</p> Signup and view all the answers

What constitutes one of the two major risk factors for Coronary Heart Disease (CHD)?

<p>Low HDL levels</p> Signup and view all the answers

What lipoprotein transports fatty acids and cholesterol derived from the diet or synthesized in the intestines from the gut to the liver?

<p>Chylomicrons</p> Signup and view all the answers

Which lipoprotein particle contains proteins on its outer surface called apolipoproteins?

<p>Chylomicrons</p> Signup and view all the answers

How much of the total cholesterol does VLDL carry in serum?

<p>~10-15%</p> Signup and view all the answers

What lipoprotein is formed in the liver and serves as a precursor for LDL?

<p>VLDL</p> Signup and view all the answers

Study Notes

Acute Coronary Syndromes

  • The predominant cause of acute coronary syndromes is plaque rupture.
  • The symptom commonly associated with acute coronary syndromes is chest pain.

Coagulation Cascade

  • Thrombin is the enzyme that converts fibrinogen to fibrin in the coagulation cascade following plaque rupture.

ECG Characteristics

  • The main characteristic of STE MI (Q-wave or transmural MI) on ECG is the presence of Q-waves.
  • The characteristic ECG finding in NSTE MI (non–Q-wave or non-transmural MI) is ST-segment depression or T-wave inversion.

Lipids and Lipoproteins

  • The major lipids found in the body are cholesterol, triglycerides, and phospholipids.
  • LDL carries 60% to 70% of the total serum cholesterol.
  • The primary target of cholesterol-lowering therapy is LDL.
  • LDL is enriched with cholesterol esters, smaller, denser, and more atherogenic than less dense VLDL.
  • VLDL carries about 10% to 15% of serum cholesterol and is a precursor for LDL.
  • Chylomicrons transport fatty acids and cholesterol derived from the diet or synthesized in the intestines from the gut to the liver.
  • Apolipoprotein B-100 is a ligand for LDL receptors on the surface of hepatocytes and peripheral cells.
  • HDL plays a small role in the pathogenesis of atherosclerosis, is large, and transports cholesterol from peripheral cells back to the liver through the process of reverse cholesterol transport.
  • LDL is formed in the liver and serves as a precursor for LDL.
  • Lipoproteins associated with abnormalities that can result in a predisposition to coronary, cerebrovascular, and peripheral vascular diseases include LDL, VLDL, and HDL.
  • Dyslipidemia can be defined as an elevation in total cholesterol, elevation in LDL cholesterol, elevation in triglycerides, or low HDL cholesterol concentration.

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