MOLECULAR AND CELL BIOLOGY OF NATIVE CORONARY AND VEIN-GRAFT ATHEROSCLEROSIS - REGULATION OF PLAQUE STABILITY AND VESSEL-WALL REMODELING BYGROWTH-FACTORS AND CELL-EXTRACELLULAR MATRIX INTERACTIONS

Atherosclerotic plaque instability underlies unstable angina, myocardi al infarction, and vein-graft occlusion. Whether in native coronary ar teries or arterial grafts, atherosclerotic plaque stability is determi ned by proliferation and migration of vascular smooth muscle cells, ac companied by the deposition of new extracellular matrices. Necrosis or apoptosis of vascular smooth muscle cells has an additional influence on the final composition and tensile strength of the plaque. In vein grafts, intimal thickening is a precursor and predisposing factor for subsequent atherosclerosis. Understanding the regulation of vascular s mooth muscle cells is thus a prerequisite for designing rational thera pies. Recent insights are summarized and unresolved questions highligh ted in this review. The role of interactions between growth factors an d extracellular matrix components as positive and negative regulators is emphasized. (C) Rapid Science Publishers.