Pathophysiological Mechanisms Linking Trans Fatty Acid Exposure to Coronary Atherosclerosis and Ischemic Stroke: A Review

Cardiovascular disease and stroke areglobal health threats. This review article aimsto systematize and clarify the pathogenesisleading to coronary artery stenosis and strokedue to industrially produced trans fatty acids(TFAs). A narrative review was conductedthrough searching PubMed and Google Scholardatabases (up to March 2026). From initialdocuments, screening was carried out in stagesto select 22 documents for inclusion in thereview. The review of studies shows that TFAspromote atherosclerosis and stroke through fourmain groups of mechanisms: (1) Dyslipidemia(elevated LDL-C, reduced HDL-C, impairedreverse cholesterol transport) and altered cellmembrane composition; (2) Activation ofsystemic and vascular inflammatory cascades(NF-κB, TLR2, TLR4), upregulating proinflammatory cytokines (IL-6, TNF-α, MCP-1)and adhesion molecules (ICAM-1, VCAM-1, E-selectin); (3) Endothelial dysfunctionand prothrombotic state, severely impairingNitric Oxide (NO) bioavailability and reducingthrombomodulin expression; (4) Promotionof oxidative stress (ROS) and endoplasmicreticulum stress, triggering ASK1-p38 MAPKand JNK-Sab-ROS signaling axes to induceapoptosis in macrophages, smooth musclecells, microglia, and neurons. Conclusion: TFAsupports atherosclerosis and stroke throughpathways ranging from simple to complex.The study’s findings may contribute to policyformulation regarding the use of industrial TFAin Vietnam.