From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient: JACC State-of-the-Art Review

Armin Arbab-Zadeh, Valentin Fuster

Research output: Contribution to journalReview articlepeer-review

Abstract

The past decades have seen tremendous progress on elucidating mechanisms leading to acute coronary syndrome and sudden cardiac death. Pathology and imaging studies have identified features of coronary atherosclerosis that precede acute coronary events. However, many factors influence the risk of adverse events from coronary atherosclerotic disease and available data support our transition from focusing on individual “vulnerable plaque,” coronary arterial stenosis, and inducible myocardial ischemia to understanding coronary heart disease as multifactorial, chronic disease. The concept of the vulnerable patient has evolved, with the atheroma burden, its metabolic activity, and the disposition to vascular thrombosis building a platform for assessing central aspects of coronary heart disease. In turn, this model has directed us to a focus on controlling the activity of atherosclerotic disease and on modifying the susceptibility of vascular thrombosis which has led to reduced morbidity and mortality from coronary heart disease.

Original languageEnglish (US)
Pages (from-to)1582-1593
Number of pages12
JournalJournal of the American College of Cardiology
Volume74
Issue number12
DOIs
StatePublished - Sep 24 2019

Keywords

  • atherosclerosis
  • coronary artery disease
  • coronary heart disease
  • coronary stenosis
  • myocardial ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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