From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient: JACC State-of-the-Art Review

The past decades have seen tremendous progress on elucidating mechanisms leading to acute coronary syndrome and sudden cardiac death. Pathology and imaging studies have identified features of coronary atherosclerosis that precede acute coronary events. However, many factors influence the risk of adv...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2019-09, Vol.74 (12), p.1582-1593
Main Authors: Arbab-Zadeh, Armin, Fuster, Valentin
Format: Article
Language:English
Subjects:
Angina pectoris
Arteriosclerosis
Atherosclerosis
Blood pressure
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Cardiovascular diseases
Chronic illnesses
Clinical outcomes
Coronary artery disease
Coronary Artery Disease - etiology
Coronary Artery Disease - prevention & control
Coronary Stenosis - etiology
Coronary Stenosis - prevention & control
Coronary vessels
Disease control
Disease prevention
Heart attacks
Humans
Intubation
Ischemia
Medical imaging
Morbidity
Myocardial ischemia
Myocardial Ischemia - etiology
Myocardial Ischemia - prevention & control
Patients
Plaque, Atherosclerotic - complications
Stenosis
Testing laboratories
Thromboembolism
Thrombosis
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The past decades have seen tremendous progress on elucidating mechanisms leading to acute coronary syndrome and sudden cardiac death. Pathology and imaging studies have identified features of coronary atherosclerosis that precede acute coronary events. However, many factors influence the risk of adverse events from coronary atherosclerotic disease and available data support our transition from focusing on individual "vulnerable plaque," coronary arterial stenosis, and inducible myocardial ischemia to understanding coronary heart disease as multifactorial, chronic disease. The concept of the vulnerable patient has evolved, with the atheroma burden, its metabolic activity, and the disposition to vascular thrombosis building a platform for assessing central aspects of coronary heart disease. In turn, this model has directed us to a focus on controlling the activity of atherosclerotic disease and on modifying the susceptibility of vascular thrombosis which has led to reduced morbidity and mortality from coronary heart disease.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2019.07.062