Author + information
- Received February 5, 2013
- Revision received May 10, 2013
- Accepted May 13, 2013
- Published online April 1, 2014.
- Rishi Puri, MB, BS,
- Stephen J. Nicholls, MB, BS, PhD,
- Stephen G. Ellis, MD,
- E. Murat Tuzcu, MD and
- Samir R. Kapadia, MD∗ ()
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- ↵∗Reprint requests and correspondence:
Dr. Samir R. Kapadia, Department of Cardiovascular Medicine, Heart and Vascular Institute, Mail Code J2-3, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Necropsy studies have outlined the morphological characteristics of high-risk, or “vulnerable,” coronary plaque segments, demonstrating the presence of inflammatory infiltrate and various compositional elements in patients who succumbed to fatal intracoronary thrombosis. However, accumulating evidence in vivo relates the overall burden of atherosclerosis, its rate of progression, and its subsequent ischemic potential with the risk for incident clinical events. These observations, coupled with the efficacy of contemporary medical therapies in reducing clinical event rates, have important implications for trial design of future human in vivo evaluations of vulnerable coronary plaque.
Dr. Nicholls has received research support from AstraZeneca, Eli Lilly, Amgen, Takeda, Roche, Novartis, Anthera, and Resverlogix; and is a consultant for AstraZeneca, Merck, CSL Behring, Boehringer Ingelheim, Takeda, Roche, Amgen, Omthera, and Reseverlogix. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 5, 2013.
- Revision received May 10, 2013.
- Accepted May 13, 2013.
- 2014 American College of Cardiology Foundation
- Pathological Observations of Lesions Causing Myocardial Infarction and Mechanisms of Plaque Progression
- Coronary Imaging of Lesions Before Causing MI
- Plaque Burden, Plaque Progression, and Clinical Events: What Is the Evidence?
- Does Ischemia Equate to a High-Risk Clinical Situation?
- Implications for Future Vulnerable Plaque Imaging Trials