What question did this study set out to answer?

This review aims to challenge the concept of vulnerable plaques in predicting acute coronary events, emphasizing the need for a broader understanding of atherosclerotic disease.

June 26, 2026Journal of the American College of Cardiology424 citations

View Full Paper

The Myth of the “Vulnerable Plaque”

AAArmin Arbab‐Zadeh VFValentı́n Fuster

Key Points

This review aims to challenge the concept of vulnerable plaques in predicting acute coronary events, emphasizing the need for a broader understanding of atherosclerotic disease.
Summarizes existing literature on vulnerable plaques and imaging techniques.
Evaluates clinical studies comparing risk prediction from vulnerable plaques with traditional methods.
Discusses the natural history of atherosclerotic plaque rupture based on pathology studies.
Clinical studies show no improvement in risk prediction through imaging of vulnerable plaques when compared to traditional methods.
Evidence indicates a complex relationship between plaque rupture and acute coronary events that traditional metrics fail to capture.
Emphasizes a need to focus on overall atherosclerotic disease burden rather than solely on individual plaque characteristics.

Abstract

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 to 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 suffering acute coronary events mandates a greater focus on the atherosclerotic disease burden, rather than on features of individual plaques.

Demander à l'IA

Bookmark

View Full Paper

Cite This Study

Arbab‐Zadeh et al. (Thu,) studied this question.

synapsesocial.com/papers/6a3defaa709b1fe706813bae https://doi.org/https://doi.org/10.1016/j.jacc.2014.11.041

Demander à l'IA

Bookmark

View Full Paper