{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:58:49Z","timestamp":1793386729658,"version":"4.5.0"},"reference-count":113,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T00:00:00Z","timestamp":1618012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>The atherothrombotic substrates for acute coronary syndromes (ACS) consist of plaque ruptures, erosions and calcified nodules, while the non-atherothrombotic etiologies, such as spontaneous coronary artery dissection, coronary artery spasm and coronary embolism are the rarer causes of ACS. The purpose of this comprehensive review is to (1) summarize the histopathologic insights into the atherothrombotic plaque subtypes in acute ACS from postmortem studies; (2) provide a brief overview of atherogenesis, while mainly focusing on the events that lead to plaque destabilization and disruption; (3) summarize mechanistic data from clinical studies that have used intravascular imaging, including high-resolution optical coherence tomography, to assess culprit plaque morphology and its underlying pathobiology, especially the newly described role of innate and adaptive immunity in ACS secondary to plaque erosion; (4) discuss the utility of intravascular imaging for effective treatment of patients presenting with ACS by percutaneous coronary intervention; and (5) discuss the opportunities that these mechanistic and imaging insights may provide for more individualized treatment of patients with ACS.<\/jats:p>","DOI":"10.3390\/cells10040865","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T03:04:06Z","timestamp":1618196646000},"page":"865","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Atherothrombosis in Acute Coronary Syndromes\u2014From Mechanistic Insights to Targeted Therapies"],"prefix":"10.3390","volume":"10","author":[{"given":"Chinmay","family":"Khandkar","sequence":"first","affiliation":[{"name":"Department of Cardiology, Orange Base Hospital, Orange, NSW 2800, Australia"},{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2008, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh V.","family":"Madhavan","sequence":"additional","affiliation":[{"name":"New York Presbyterian Hospital\/Columbia University Irving Medical Center, New York, NY 10032, USA"},{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY 10019, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2008, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia"},{"name":"Heart Research Institute, Sydney, NSW 2042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Celermajer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2008, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia"},{"name":"Heart Research Institute, Sydney, NSW 2042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyvan","family":"Karimi Galougahi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2008, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia"},{"name":"Heart Research Institute, Sydney, NSW 2042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1056\/NEJM199705013361802","article-title":"Coronary risk factors and plaque morphology in men with coronary disease who died suddenly","volume":"336","author":"Burke","year":"1997","journal-title":"N. 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