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The myth of the "vulnerable plaque": transitioning from a focus on individual lesions to atherosclerotic disease burden for coronary artery disease risk assessment

Journal of the American College of Cardiology, 2015-03, Vol.65 (8), p.846-855 [Peer Reviewed Journal]

Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;2014 Elsevier Inc. All rights reserved. 2014 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2014.11.041 ;PMID: 25601032

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Title:
The myth of the "vulnerable plaque": transitioning from a focus on individual lesions to atherosclerotic disease burden for coronary artery disease risk assessment
Author: Arbab-Zadeh, Armin ; Fuster, Valentin
Subjects: Cardiac Imaging Techniques - trends ; Coronary Artery Disease - complications ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - etiology ; Coronary Artery Disease - physiopathology ; Cost of Illness ; Humans ; Plaque, Atherosclerotic - diagnosis ; Plaque, Atherosclerotic - physiopathology ; Predictive Value of Tests ; Risk Assessment
Is Part Of: Journal of the American College of Cardiology, 2015-03, Vol.65 (8), p.846-855
Description: The cardiovascular science community has pursued the quest to identify vulnerable atherosclerotic plaque in patients for decades, hoping to prevent acute coronary events. However, despite major advancements in imaging technology that allow visualization of rupture-prone plaques, clinical studies have not demonstrated improved risk prediction compared with traditional approaches. Considering the complex relationship between plaque rupture and acute coronary event risk suggested by pathology studies and confirmed by clinical investigations, these results are not surprising. This review summarizes the evidence supporting a multifaceted hypothesis of the natural history of atherosclerotic plaque rupture. Managing patients at risk of acute coronary events mandates a greater focus on the atherosclerotic disease burden rather than on features of individual plaques.
Publisher: United States
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2014.11.041
PMID: 25601032
Source: Geneva Foundation Free Medical Journals at publisher websites
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