Current status of vulnerable plaque detection.

Hdl Handle:
http://hdl.handle.net/10147/207817
Title:
Current status of vulnerable plaque detection.
Authors:
Sharif, Faisal; Murphy, Ross T
Affiliation:
Department of Cardiology, St James' Hospital, St James' Street, Dublin 8,, Ireland. faisalshareef@yahoo.com
Citation:
Catheter Cardiovasc Interv. 2010 Jan 1;75(1):135-44.
Journal:
Catheterization and cardiovascular interventions : official journal of the, Society for Cardiac Angiography & Interventions
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207817
DOI:
10.1002/ccd.22164
PubMed ID:
19670307
Abstract:
Critical coronary stenoses have been shown to contribute to only a minority of acute coronary syndromes (ACS) and sudden cardiac death. Autopsy studies have identified a subgroup of high-risk patients with disrupted vulnerable plaque and modest stenosis. Consequently, a clinical need exists to develop methods to identify these plaques prospectively before disruption and clinical expression of disease. Recent advances in invasive and noninvasive imaging techniques have shown the potential to identify these high-risk plaques. The anatomical characteristics of the vulnerable plaque such as thin cap fibroatheroma and lipid pool can be identified with angioscopy, high frequency intravascular ultrasound, intravascular MRI, and optical coherence tomography. Efforts have also been made to recognize active inflammation in high-risk plaques using intravascular thermography. Plaque chemical composition by measuring electromagnetic radiation using spectroscopy is also an emerging technology to detect vulnerable plaques. Noninvasive imaging with MRI, CT, and PET also holds the potential to differentiate between low and high-risk plaques. However, at present none of these imaging modalities are able to detect vulnerable plaque neither has been shown to definitively predict outcome. Nevertheless in contrast, there has been a parallel development in the physiological assessment of advanced atherosclerotic coronary artery disease. Thus recent trials using fractional flow reserve in patients with modest non flow-limiting stenoses have shown that deferral of PCI with optimal medical therapy in these patients is superior to coronary intervention. Further trials are needed to provide more information regarding the natural history of high-risk but non flow-limiting plaque to establish patient-specific targeted therapy and to refine plaque stabilizing strategies in the future.
Language:
eng
MeSH:
Coronary Stenosis/complications/*diagnosis; *Diagnostic Imaging/methods; Humans; Predictive Value of Tests; Severity of Illness Index
ISSN:
1522-726X (Electronic); 1522-1946 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorSharif, Faisalen_GB
dc.contributor.authorMurphy, Ross Ten_GB
dc.date.accessioned2012-02-01T10:45:33Z-
dc.date.available2012-02-01T10:45:33Z-
dc.date.issued2012-02-01T10:45:33Z-
dc.identifier.citationCatheter Cardiovasc Interv. 2010 Jan 1;75(1):135-44.en_GB
dc.identifier.issn1522-726X (Electronic)en_GB
dc.identifier.issn1522-1946 (Linking)en_GB
dc.identifier.pmid19670307en_GB
dc.identifier.doi10.1002/ccd.22164en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207817-
dc.description.abstractCritical coronary stenoses have been shown to contribute to only a minority of acute coronary syndromes (ACS) and sudden cardiac death. Autopsy studies have identified a subgroup of high-risk patients with disrupted vulnerable plaque and modest stenosis. Consequently, a clinical need exists to develop methods to identify these plaques prospectively before disruption and clinical expression of disease. Recent advances in invasive and noninvasive imaging techniques have shown the potential to identify these high-risk plaques. The anatomical characteristics of the vulnerable plaque such as thin cap fibroatheroma and lipid pool can be identified with angioscopy, high frequency intravascular ultrasound, intravascular MRI, and optical coherence tomography. Efforts have also been made to recognize active inflammation in high-risk plaques using intravascular thermography. Plaque chemical composition by measuring electromagnetic radiation using spectroscopy is also an emerging technology to detect vulnerable plaques. Noninvasive imaging with MRI, CT, and PET also holds the potential to differentiate between low and high-risk plaques. However, at present none of these imaging modalities are able to detect vulnerable plaque neither has been shown to definitively predict outcome. Nevertheless in contrast, there has been a parallel development in the physiological assessment of advanced atherosclerotic coronary artery disease. Thus recent trials using fractional flow reserve in patients with modest non flow-limiting stenoses have shown that deferral of PCI with optimal medical therapy in these patients is superior to coronary intervention. Further trials are needed to provide more information regarding the natural history of high-risk but non flow-limiting plaque to establish patient-specific targeted therapy and to refine plaque stabilizing strategies in the future.en_GB
dc.language.isoengen_GB
dc.subject.meshCoronary Stenosis/complications/*diagnosisen_GB
dc.subject.mesh*Diagnostic Imaging/methodsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshSeverity of Illness Indexen_GB
dc.titleCurrent status of vulnerable plaque detection.en_GB
dc.contributor.departmentDepartment of Cardiology, St James' Hospital, St James' Street, Dublin 8,, Ireland. faisalshareef@yahoo.comen_GB
dc.identifier.journalCatheterization and cardiovascular interventions : official journal of the, Society for Cardiac Angiography & Interventionsen_GB
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.