Intraplaque haemorrhages as the trigger of plaque vulnerability
Key result
Intraplaque neovascularization and bleeding are linked to plaque progression and may predict future atherothrombotic events.
Why the study?
Current prevention and interventional strategies have not eliminated high cardiovascular event rates, reflecting an incomplete understanding of the pathophysiology leading to clinical atherothrombosis.
Design
Review
Authors
Discussion
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Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The best predictor of which patient had a stroke was the presence of complex carotid plaque with evidence of hemorrhage or bleeding into it. We found that this imaging finding performed better than any other clinical marker as to whether the patient had a stroke on a certain side of their brain. So, this study corroborated with in vivo evidence the ongoing theories of what leads to a stroke or heart attack.”
Implication
Supports plaque hemorrhage imaging for refined atherothrombotic risk stratification; leaves open anti-neovascular therapies pending randomized validation.
Key Points
- This research examines the impact of intraplaque hemorrhages on plaque vulnerability and its implications for atherothrombosis.
- Review of recent studies on intraplaque neovascularization and bleeding
- Analysis of biological processes related to atherothrombosis
- Assessment of the clinical importance of intraplaque events
- Intraplaque hemorrhages are linked to plaque progression and leukocyte infiltration
- These events may serve as indicators of future acute clinical events
- Current treatments focusing only on metabolic risk are inadequate in reducing cardiovascular mortality
PICO
P
Population
Atherothrombosis
Intraplaque hemorrhage and neovascularization are emerging as critical pathophysiological triggers for plaque vulnerability, offering potential new targets for predicting and treating atherothrombotic disease.
Cite This Study
Michel et al. (2011) conducted a review in Atherothrombosis. Intraplaque neovascularization and bleeding play a major role in plaque progression and may serve as a measure of risk for the development of future atherothrombotic events.