Despite the insights offered by high-resolution IVI, vulnerable plaques should be considered as markers of global patient risk rather than reliable predictors of culprit lesions. Current evidence does not support routine pre-emptive intervention on non-culprit vulnerable plaques. Instead, optimized medical therapy remains the cornerstone of management. Future progress will depend on longitudinal studies integrating imaging, biology and clinical outcomes to bridge the gap between mechanistic understanding and therapeutic application.
Elia et al. (Wed,) studied this question.