Although mortality rates from coronary heart disease in the western countries have declined in the last few decades, morbidity caused by this disease is increasing and a substantial number of patients still suffer acute coronary syndrome (ACS) and sudden cardiac death. Acute coronary syndrome occurs as a result of myocardial ischaemia and its manifestations include acute myocardial infarction and unstable angina. Culprit plaque morphology in these patients varies from thrombosis with or without coronary occlusion to sudden narrowing of the lumen from intraplaque haemorrhage. The coronary artery plaque morphologies primarily responsible for thrombosis are plaque rupture, and plaque erosion, with ...

Since its introduction over 20 years ago, intravascular ultrasound (IVUS) has become the dominant imaging technology, helping us to better understand vessel biology and guiding interventional procedures, and providing information on atherosclerosis progression or regression in clinical trials. During this time period, IVUS has survived many other intracoronary techniques that have fallen by the wayside. Recently, optical coherence tomography (OCT), a far higher resolution optical imaging technique, was approved for clinical use by the U.S. Food and Drug Administration. Suter et al. (1), in a State-of-the-Art review article in this issue of iJACC, have highlighted the relative merits of ...