1. The coronary substrate determines prognosis in acute coronary syndromes: the kaleidoscope has been shaken ... again!

    The coronary substrate determines prognosis in acute coronary syndromes: the kaleidoscope has been shaken ... again!

    The identification of ‘vulnerable’ or ‘high risk’ coronary plaques has represented the quest for the Holy Grail in interventional cardiology for the past three decades. Plaque rupture (PR), plaque erosion (PE), and complicated calcified nodules (CNs) constitute the most common underlying substrates leading to coronary thrombosis and acute coronary syndromes (ACS). 1 – 3 Despite the advent of novel intracoronary imaging techniques, which are able to disclose unique morphological insights and plaque features similar to those found in plaques already complicated with coronary thrombosis, their value in predicting future clinical events remains limited. 4 – 7 Optical coherence tomography (OCT) is an ...

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