Detection of the vulnerable coronary atheromatous plaque. Where are we now?

Area of Science:

• Cardiovascular Medicine
• Pathology
• Medical Imaging

Background:

• Atherosclerosis is a primary cause of death globally, driven by endothelial dysfunction, lipid accumulation, and inflammation.
• Plaque rupture, leading to acute coronary syndromes, often occurs in non-severely stenotic lesions.
• High-risk plaques are characterized by lipid-rich cores, thin fibrous caps, and inflammatory cell infiltration.

Purpose of the Study:

• To emphasize the critical role of plaque composition in cardiovascular events.
• To highlight the need for advanced diagnostic tools for high-risk plaque detection.
• To improve risk stratification and therapeutic selection for atherosclerosis patients.

Main Methods:

• Review of current understanding of atherosclerosis pathophysiology.
• Analysis of factors contributing to plaque vulnerability and rupture.
• Discussion of the importance of diagnostic modality development.

Main Results:

• Plaque composition, not just stenosis degree, dictates rupture risk.
• Lipid-rich, thin-cap plaques with inflammation are highly prone to rupture.
• Current diagnostic methods may not fully characterize high-risk plaques.

Conclusions:

• Accurate detection and characterization of high-risk atheromatous plaques are essential.
• Improved diagnostic techniques can aid in risk stratification.
• Targeted therapies based on plaque characterization can optimize patient management.