Platelet biology and function: plaque erosion vs. rupture

European Heart Journal, vol. 45, pp. 18–31

Abstract

The leading cause of heart disease in developed countries is coronary atherosclerosis, which is not simply a result of ageing but a chronic inflammatory process that can lead to acute clinical events upon atherosclerotic plaque rupture or erosion and arterial thrombus formation. The composition and location of atherosclerotic plaques determine the phenotype of the lesion and whether it is more likely to rupture or to erode. Although plaque rupture and erosion both initiate platelet activation on the exposed vascular surface, the contribution of platelets to thrombus formation differs between the two phenotypes. In this review, plaque phenotype is discussed in relation to thrombus composition, and an overview of important mediators (haemodynamics, matrix components, and soluble factors) in plaque-induced platelet activation is given. As thrombus formation on disrupted plaques does not necessarily result in complete vessel occlusion, plaque healing can occur. Therefore, the latest findings on plaque healing and the potential role of platelets in this process are summarized. Finally, the clinical need for more effective antithrombotic agents is highlighted.

Authors 5

1. Constance C. F. M. J. Baaten Aachen Institute for Molecular Cardiovascular Research

   Maastricht University · Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University , Universiteitssingel 50, 6229 ER, Maastricht , the Netherlands

   Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen , Aachen , Germany

2. Magdolna Nagy

   Maastricht University

   Affiliation as printed

   Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University , Universiteitssingel 50, 6229 ER, Maastricht , the Netherlands

3. Wolfgang Bergmeier

   University of North Carolina at Chapel Hill

   Affiliation as printed

   Blood Research Center, School of Medicine, University of North Caroline at Chapel Hill , Chapel Hill, NC , USA

   Department of Biochemistry and Biophysics, School of Medicine, University of North Caroline at Chapel Hill , Chapel Hill, NC , USA

4. Henri M.H. Spronk

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University , Universiteitssingel 50, 6229 ER, Maastricht , the Netherlands

   Department of Internal Medicine, Maastricht University Medical Center+ , Maastricht , the Netherlands

   Thrombosis Expertise Center, Heart+ Vascular Center, Maastricht University Medical Center+ , P. Debeyelaan 25, Maastricht , the Netherlands

5. Paola E. J. van der Meijden corresponding

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University , Universiteitssingel 50, 6229 ER, Maastricht , the Netherlands

   Thrombosis Expertise Center, Heart+ Vascular Center, Maastricht University Medical Center+ , P. Debeyelaan 25, Maastricht , the Netherlands