What is atheromatous plaque (atherosclerotic plaque)?

From the Guidelines

Plaque is a buildup of fatty deposits, cholesterol, and other substances in the arteries, which can lead to atherosclerosis and increase the risk of heart disease and stroke. In simple terms, plaque is like a thick, hard substance that can clog the arteries, making it harder for blood to flow through them. This can happen when there is too much cholesterol and other substances in the blood, and the arteries become damaged. Over time, plaque can build up and cause the arteries to narrow, leading to a range of health problems, including heart attacks, strokes, and peripheral artery disease. According to the study by 1, the risk of plaque disruption depends on plaque composition and vulnerability, and even portions of the coronary arterial tree that appear normal by angiographic criteria often harbor a substantial burden of atherosclerosis.

Some key points to note about plaque include:

• Plaque can start to build up in the arteries from a young age, and can be influenced by a range of factors, including diet, lifestyle, and genetics 1
• The extent of coronary calcifications correlates with the extent of the total coronary plaque burden, and can be an indicator of atherosclerotic disease 1
• Plaque characteristics, such as the presence of echolucent or calcified plaques, can be predictive of subsequent cerebral ischemic events 1
• The risk of plaque disruption and subsequent cardiovascular events can be increased by factors such as physical or emotional stress, and can be influenced by the use of certain medications or therapies 1

It's worth noting that while the provided evidence discusses plaque in the context of cardiovascular disease, the question asks for a definition of plaque in layman's terms. However, based on the most recent and highest quality study, the definition of plaque as a buildup of fatty deposits, cholesterol, and other substances in the arteries is the most accurate and relevant definition. This definition is supported by the study by 1, which discusses the importance of evaluating patients with coronary artery disease and making recommendations for athletic competition.

In terms of prevention and management, there are several steps that can be taken to reduce the risk of plaque buildup and cardiovascular disease, including:

• Eating a healthy diet that is low in saturated fats and high in fruits, vegetables, and whole grains
• Getting regular exercise, such as walking or jogging, to help improve cardiovascular health
• Not smoking, and avoiding exposure to secondhand smoke
• Managing stress through techniques such as meditation or yoga
• Getting regular check-ups with a healthcare provider to monitor cardiovascular health and catch any potential problems early.

From the Research

Definition of Plaque

• Plaque is a buildup of fatty deposits, cholesterol, and other substances in the arteries, which can lead to atherosclerosis and increase the risk of heart disease and stroke 2, 3.
• It is a complex lesion that consists of a lipid-rich necrotic core, a thin fibrous cap, and inflammatory cells, which can rupture and cause thrombosis 2, 3.
• Plaque formation is a gradual process that occurs over many years, and it is influenced by various factors, including high blood pressure, high cholesterol, smoking, and diabetes 2, 3.

Characteristics of Plaque

• Plaque can be stable or unstable, with unstable plaque being more prone to rupture and causing thrombosis 2, 3.
• The severity of plaque can be assessed using various imaging techniques, including electron-beam computed tomography, which can measure the volume of coronary calcification and estimate the total burden of atherosclerotic plaque 4.
• Plaque burden, activity, and vulnerability are important concepts in understanding the progression of atherosclerosis and the risk of thrombosis 2, 3.

Treatment and Prevention of Plaque

• Statins, or HMG-CoA reductase inhibitors, are a type of medication that can help reduce the risk of plaque formation and rupture by lowering cholesterol levels and stabilizing plaque 5, 4, 6.
• Other lipid-lowering medications and antiplatelet therapy may also be used to reduce the risk of plaque formation and thrombosis, although their effectiveness may vary 6.
• Lifestyle changes, such as a healthy diet, regular exercise, and quitting smoking, can also help reduce the risk of plaque formation and atherosclerosis 2, 3.