5. Coronary Arteries
The coronary arteries are commonly involved and this is not surprising. These are unique arteries. They are different from the arteries in the rest of the body. It is important to stress that these arteries collapse during the systolic contraction of the heart. They fill intermittently during diastole when the heart is relaxed. This intermittent flow to cardiac muscles that work harder and longer than any muscles in the body probably cause hemodynamic injury to the coronary arterial wall.
Agents that reduce turbulence and velocity of flow, particularly the beta-blocking drugs, may prove beneficial in clinical trials when used in conjunction with statins to reduce LDL cholesterol levels to less than 80 mg/dl in younger individuals at risk. It is of interest that in the management of patients with ruptured aortic aneurysms or dissecting aneurysms a beta-blocking drug is given immediately to quell the ejection velocity of blood that further tears the ruptured artery. 6. Angiogenesis in Plaques
During the past decade therapeutic angiogenesis has come into vogue. The use of angiogenic peptides is believed to produce therapeutic angiogenesis in the heart to improve blood supply and oxygen to muscles deprived of blood. Unfortunately, this may not be such a good therapeutic strategy. Muir’s textbook of pathology from 1958 states:

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