Hemostasis involves a carefully regulated balance between circulating and endothelium-
derived prothrombotic and antithrombotic factors. The unstable or vulnerable plaque
facilitates thrombosis, clinically manifest as an acute coronary syndrome (ACS), by creating
an environment that favors thrombus formation over prevention of lysis. Endothelial cell
dysfunction is integral to both the development of the atherosclerotic lesion as well as its
destabilization. The transformation of a stable plaque to an unstable one involves complex …