1. In search of the thrombosis-prone vulnerable plaque

    In search of the thrombosis-prone vulnerable plaque

    The symptomatic plaques that do get treated don't tend to be the dangerous ones. For many cardiologists, the holy grail of prevention is to identify thrombosis-prone (vulnerable) plaques before they rupture. A Symposium will review the latest advances in imaging and biomarkers, and ask whether such techniques provide added value to conventional screening.Introducing the vulnerable plaque concept, Professor Erling Falk, a cardiovascular pathologist from the University of Aarhus, Denmark, will explain that most heart attacks occur in people with average levels of risk factors who would not be considered eligible for preventive treatment. “In fact," he says, "if ...

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    1. Atherosclerosis is a multifocal disease, there's never one single plaque, and the symptomatic plaques that do get treated today don't tend to be the dangerous ones.
    2. The technique allows high-resolution arterial-wall imaging in the range of 10-20 microns, allowing penetrance into the arterial wall and visualisation of specific components of the atherosclerotic plaques, including calcification, fibrotic tissue, necrotic lipid pools and thrombotic components.
    3. For markers to become a usable concept we need to show they increase predictive power over known risk factors...Just because a plaque ruptures doesn't necessarily mean it will result in clinical complications. For the holistic picture we need also to think of the vulnerable blood and vulnerable patient
    4. While such tests don't distinguish between malignant and benign atherosclerosis.
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