TRADITIONAL AND NOVEL RISK FACTORS IN ATHEROTHROMBOSIS Edited by Efraín Gaxiola Traditional and Novel Risk Factors in Atherothrombosis Edited by Efraín Gaxiola Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Anja Filipovic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published April, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Traditional and Novel Risk Factors in Atherothrombosis, Edited by Efraín Gaxiola p. cm. ISBN 978-953-51-0561-9 Contents Preface IX Chapter 1 Pathology and Pathophysiology of Atherothrombosis: Virchow’s Triad Revisited 1 Atsushi Yamashita and Yujiro Asada Chapter 2 Biomarkers of Atherosclerosis and Acute Coronary Syndromes – A Clinical Perspective 21 Richard Body, Mark Slevin and Garry McDowell Chapter 3 Roles of Serotonin in Atherothrombosis and Related Diseases 57 Takuya Watanabe and Shinji Koba Chapter 4 Endothelial Progenitor Cell in Cardiovascular Diseases 71 Po-Hsun Huang Chapter 5 CD40 Ligand and Its Receptors in Atherothrombosis 79 Daniel Yacoub, Ghada S. Hassan, Nada Alaadine, Yahye Merhi and Walid Mourad Chapter 6 In Search for Novel Biomarkers of Acute Coronary Syndrome 97 Kavita K. Shalia and Vinod K. Shah Chapter 7 Lower Extremity Peripheral Arterial Disease 119 Aditya M. Sharma and Herbert D. Aronow Preface Atherothrombosis has reached pandemic proportions worldwide. It is the underlying condition that results in events leading to myocardial infarction, ischemic stroke and vascular death. As such, it is the leading cause of death worldwide manifested mainly as cardiovascular/cerebrovascular death. As the population of many countries becomes more aged, so the burden of atherothrombosis increases. The burden of atherothrombosis is felt in numerous ways: shortened life expectancy, increased morbidity and mortality and future risk of consequences in multiple systems. Although therapeutic improvements and public health policies for risk factors control have brought about a reduction in atherothrombosis among the general population, this success has not been extended to some group populations as diabetics. The complex and intimate relationship between atherothrombosis and traditional and novel risk factors is discussed in the following chapters of Traditional and Novel Risk Factors in Atherothrombosis – from basic science to clinical and therapeutic concerns. Beginning with pathology and pathophysiology of atherothrombosis, plaque rupture/disruption, this book continues with molecular, biochemical, inflammatory, cellular aspects and finally analyzes several aspects of clinical pharmacology. This book is made up of seven chapters. In the first, Yamashita and Asada delineate the pathophysiologic mechanisms of plaque disruption and thrombus formation as critical steps for the onset of cardiovascular events, and that simultaneous activation of coagulation cascade and platelets play an important role in thrombus formation after plaque disruption. Next, Body, Slevin and McDowell discuss current methods for assessment of the presence, degree of severity and ‘plaque composition’ in patients with atherosclerosis, incuding current and novel imaging technology and measurement of circulating biomarkers of atherosclerosis. Subsequently, Watanabe and Koba clarify the roles of Serotonin in atherothrombosis and its related diseases, and how serotonin plays a crucial role in the formation of thrombosis and atherosclerotic lesions through 5-HT 2A receptors. Po-Hsun Huang analyzes the therapeutic use of endothelial progenitor cell in cardiovascular diseases. Yacoub, Hassan, Alaadine, Merhi, and Mourad discuss the role of CD40 Ligand and its X Preface receptors in atherothrombosis. They show that besides its pivotal role in humoral immunity, CD40L is now regarded as a key player to all major phases of atherothrombosis, a concept supported in part by the strong relationship between its circulating soluble levels and the occurrence of cardiovascular diseases. The last two chapters are dedicated to diagnostic and therapeutic issues. Shalia and Shah describe the current use of diagnostic biomarkers in ACS, as well as novel cardiac biomarkers of ACS. Sharma and Aronow talk about the optimal diagnosis and management of lower extremity peripheral arterial disease, detailing both the classical and modern therapeutic options. I would like to pay tribute and express our appreciation to the distinguished and internationally renowned collaborators of this book for their outstanding contribution. Despite their many commitments and busy time schedules, all of them enthusiastically stated their acquiescence to cooperate. This book could not have become a reality were it not for their dedicated efforts. Efraín Gaxiola, MD, FACC Cardiology Chief Jardínes Hospital de Especialidades Guadalajara, México . TRADITIONAL AND NOVEL RISK FACTORS IN ATHEROTHROMBOSIS Edited by Efraín Gaxiola Traditional and Novel Risk Factors in Atherothrombosis. between atherothrombosis and traditional and novel risk factors is discussed in the following chapters of Traditional and Novel Risk Factors in Atherothrombosis