Key result
Vulnerable coronary plaques, the initiating lesions in most acute coronary syndromes, can now be identified in vivo using intravascular ultrasound and MRI to guide future plaque stabilization therapies.
This review highlights the pathophysiology of vulnerable coronary plaques and the emerging role of advanced imaging techniques in identifying them to prevent acute coronary syndromes.
May support imaging-guided plaque stabilization research; leaves open clinical adoption pending randomized outcome trials.
Vulnerable coronary plaques are asymptomatic atherosclerotic lesions with the tendency to rupture. Plaque rupture is the initiating event in most acute coronary syndromes including sudden cardiac death, acute myocardial infarction, and unstable angina. Vulnerable plaques are commonly found in coronary arteries at autopsy but are virtually undetectable by standard diagnostic techniques such as stress testing and coronary angiography. Using new imaging techniques, in particular intravascular ultrasound and magnetic resonance imaging (MRI), scientists are now able to identify these plaques in vivo. A better understanding of the pathophysiology of plaque vulnerability and rupture will eventually lead to the therapeutic goal of plaque stabilization in the prevention of acute coronary syndromes. This article reviews the role of plaque vulnerability in coronary artery disease. The anatomy and pathophysiology of vulnerable plaques as well as diagnostic and therapeutic implication will be described.
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Schoenhagen et al. (2000) conducted a review in Coronary artery disease. Vulnerable coronary plaques, the initiating lesions in most acute coronary syndromes, can now be identified in vivo using intravascular ultrasound and MRI to guide future plaque stabilization therapies.
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