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Nat Rev Cardiol ; 13(5): 257-65, 2016 May.
Article in English | MEDLINE | ID: mdl-26911330

ABSTRACT

The latest advances in plaque imaging have provided clinicians with opportunities to treat acute coronary syndrome (ACS) and provide individualized treatment recommendations based not only on clinical manifestations, angiographic characteristics, and biomarker data, but also on the findings of plaque morphology. Although a substantial proportion of ACS events originate from plaques with an intact fibrous cap (IFC), clinicians predominantly equate ACS with plaque rupture arising from thin-cap fibroatheromas. In this Review, we discuss the recent advances in our understanding of plaque morphology in ACS with IFC, reviewing contemporary data from intravascular imaging. We also explore whether use of such imaging might provide a roadmap for more effective management of patients with ACS.


Subject(s)
Acute Coronary Syndrome/etiology , Coronary Artery Disease/complications , Coronary Vessels/pathology , Plaque, Atherosclerotic , Acute Coronary Syndrome/pathology , Acute Coronary Syndrome/therapy , Aged , Biopsy , Coronary Angiography , Coronary Artery Disease/pathology , Coronary Artery Disease/therapy , Coronary Vessels/diagnostic imaging , Diagnostic Imaging/methods , Fibrosis , Humans , Male , Predictive Value of Tests , Prognosis , Risk Factors , Rupture, Spontaneous , Tomography, Optical Coherence , Ultrasonography, Interventional
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