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Plaque rupture and erosion

Despite improvement in the treatment, prevention, and risk factor management of atherosclerosis, the most frequent cause of death globally remains coronary artery disease. Therefore, it is essential to understand the underlying mechanisms involved in the manifestation of acute coronary syndromes, sudden cardiac death, or stable ischaemic heart disease. Coronary atherothrombosis is the main underlying cause of acute coronary syndromes. This chapter discusses the two most frequent causes of atherothrombosis, that is, plaque rupture and plaque erosion, in patients presenting with acute myocardial infarction or sudden coronary death, including differences in the incidence, aetiology, morphological features, and risk factors that lead to plaque rupture and erosion.