For patients



What exactly is atherosclerosis?

A. Zirlik, Freiburg

Atherosclerosis, with its associated diseases such as heart attack, heart failure, stroke, and peripheral arterial disease—to name just the most important—is one of the world's leading killers. Our understanding of this disease has fundamentally changed in the last two decades. While it was previously thought to be a simple case of arteriosclerosis with secondary arterial narrowing leading to occlusion, we now know that it is a complex, chronic inflammatory disease process affecting the entire body. Likely triggered by cholesterol deposits, particularly LDL cholesterol, and its oxidative modification, the inner lining of the blood vessels, the endothelium, is activated. Inflammatory cells are attracted and migrate into the vessel wall. Under the influence of a multitude of pro-inflammatory cytokines, plaque growth and remodeling processes within the plaque then occur. Either a stable, narrowing lesion develops, triggering the typical symptoms of coronary artery disease, namely angina pectoris (exercise-related chest pain), or the local cytokine environment causes it to transform into an unstable lesion, which can eventually rupture and lead to a life-threatening heart attack.

We do not yet fully understand the precise processes that control the development of such atherosclerotic processes. However, we do know from large retrospective histopathological studies that lesions are particularly prone to rupture when they contain many inflammatory cells and lipids, but few smooth muscle cells and collagen fibers. Conversely, lesions with few inflammatory cells and lipids, but rich in smooth muscle cells and collagen fibers, tend to be more stable.

The DGAF provides a forum for atherosclerosis researchers and addresses all scientific questions related to atherosclerosis, from lipid metabolism to immunology. In doing so, we make a significant contribution to a better understanding of this disease, with the aim of advancing the development of new treatment options.