
Plate 39 
oronary Heart Diseas
Mechanisms in the initiation and progression o
 atherosclerosis. Endothelial injury results 
rom a variet
of factors such as smoking, high blood cholesterol and homocysteine, and ulceration of atherosclerotic plaques, etc. 
see text
. 
t t
e s
t
of endothelial injury, there is a downregulation of endothelial-derived nitric oxide (N
), tissue plasminogen activator (tPA), and prostacycli
(P
 with increased adhesion of platelets and leukocytes, increased permeability to lipoproteins, and vasoconstriction. ADP, aden
s
n
diphosphate; LDL, low-density lipoprotein; PAF, platelet activating factor. From Lefkowitz RJ and Willerson JT
2001
 Prospects
o
car
ovascu
ar researc
.
ournal o
 the American Medical Associatio
 285: 581-587 w
t
 perm
ss
on