Stable angina pectoris: recent advances in predicting prognosis and treatment

Substantial progress has been made in the ability to predict individuals at the highest risk of acute myocardial infarction and occlusive cerebrovascular events, as well as in the ability to reduce these risks by vigorous reductions in serum cholesterol and LDL cholesterol concentrations. The development of stents has been a clear advance in the interventional treatment of coronary heart disease in that stents provide an effective acute treatment for significant coronary narrowings in symptomatic patients and reduce the risk of restenosis lesions subsequently. Heparin-coated stents appear to provide additive protection against the risk of thrombosis and the future development of restenosis lesions. Preliminary studies done on human carotid atherosclerotic plaque suggest that unstable plaque might be detected in the future by their temperature heterogeneity, which helps identify plaques with relatively thin fibrous caps, marked inflammation, and adjacent lipid pools.