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How do foam cells contribute to the growth of an atherosclerotic plaque?

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The role of coronary artery disease in heart attack — cardiovascular disease This micrograph shows a cross section of a coronary artery narrowed by an atherosclerotic plaque (purplish matter inside the artery). Most heart attacks are caused by the rupture of an atherosclerotic plaque, which triggers the formation of a clot that abruptly blocks blood flow to part of the heart muscle.

In the context of atherosclerosis, foam cells play a critical role in the progression of arterial plaques. When cholesterol and other lipids deposit in the innermost layer of an artery, the body recruits white blood cells known as macrophages to remove these fatty substances.1

As macrophages ingest the lipids, they become swollen and vacuolated, transforming into what are known as foam cells. These cells eventually become inefficient at clearing the lipid deposits and undergo cell death. The accumulation of these dead, lipid-filled cells at the site of the original deposition causes the focal deposits to grow in size and thickness, ultimately forming atherosclerotic plaques. This process is a central feature of the disease's pathology, as the continued incorporation of lipoproteins drives the progressive development of these plaques.21