title: High-risk coronary atheroma: the interplay between ischemia, plaque burden, and disease progression.
abstract: Necropsy studies have outlined the morphological characteristics of high-risk, or "vulnerable," coronary plaque segments, demonstrating the presence of inflammatory infiltrate and various compositional elements in patients who succumbed to fatal intracoronary thrombosis. However, accumulating evidence in vivo relates the overall burden of atherosclerosis, its rate of progression, and its subsequent ischemic potential with the risk for incident clinical events. These observations, coupled with the efficacy of contemporary medical therapies in reducing clinical event rates, have important implications for trial design of future human in vivo evaluations of vulnerable coronary plaque.
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Rishi
authors.initials: R
authors.lastname: Puri
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Nicholls
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Ellis
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: kapadis@ccf.org.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D002986:Clinical Trials as Topic; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000473:pathology; D023921:Coronary Stenosis / Q000209:etiology / Q000473:pathology; D003328:Coronary Thrombosis / Q000209:etiology / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D017202:Myocardial Ischemia / Q000209:etiology* / Q000473:pathology; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000473:pathology; D012421:Rupture; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional
keywords: atherosclerosis; myocardial infarction; myocardial ischemia; plaque