The Myth of the Vulnerable Plaque Transitioning From a Focus on Individual Lesions to Atherosclerotic Disease Burden for Coronary Artery Disease Risk Assessment

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:65

Review

Arbab-Zadeh, Armin¹  Fuster, Valentin² 

[1] Johns Hopkins Univ, Dept Med, Div Cardiol, Baltimore, MD 21287 USA

[2] Mt Sinai Med Ctr, Mt Sinai Sch Med, New York, NY 10029 USA

关键词: atherosclerosis;    coronary heart disease;    coronary imaging;    prevention;   

DOI  :  10.1016/j.jacc.2014.11.041

来源: Elsevier

【 摘 要 】

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 with 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 acute coronary events mandates a greater focus on the atherosclerotic disease burden rather than on features of individual plaques. (C) 2015 by the American College of Cardiology Foundation.

【 授权许可】

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