Imaging atherosclerosis in the vulnerable patient

Excerpt

Atherosclerotic disease results in several million deaths annually. Identification of high-risk atherosclerotic lesions prone to rupture and thrombosis may greatly decrease the morbidity and mortality associated with atherosclerosis. A consensus document from the Screening for Heart Attack Prevention and Education (SHAPE) Task Force [1, 2] concludes the following: (1) All types of atherosclerotic plaques with a high likelihood of thrombotic complications and rapid progression should be considered as vulnerable plaques. (2) Vulnerable plaques are not the only culprit factors in the development of acute coronary syndromes, infarction and cardiac death. Vulnerable blood (prone to thrombosis) and vulnerable myocardium (prone to fatal arrhythmia) play an important role in the outcome. Therefore, the term “vulnerable patient” may be more appropriate to identify subjects with a high likelihood of developing cardiac events in the near future. (3) A method for cumulative risk assessment of vulnerable patients needs to be developed that may include variables based on plaque, blood and myocardial vulnerability. …