The vulnerable coronary plaque: update on imaging technologies

Gian Marco Rosa; Matteo Bauckneht; Giovanni Masoero; François Mach; Alessandra Quercioli; Sara Seitun; Manrico Balbi; Claudio Brunelli; Antonello Parodi; Alessio Nencioni; Nicolas Vuilleumier; Fabrizio Montecucco

doi:10.1160/TH13-02-0121

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2013; 110(04): 706-722
DOI: 10.1160/TH13-02-0121

Review Article

Schattauer GmbH

The vulnerable coronary plaque: update on imaging technologies

Authors

Gian Marco Rosa

¹Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
Matteo Bauckneht

¹Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
Giovanni Masoero

¹Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
François Mach

²Division of Cardiology, Department of Internal Medicine, Foundation for Medical researches, University of Geneva, Geneva, Switzerland
Alessandra Quercioli

²Division of Cardiology, Department of Internal Medicine, Foundation for Medical researches, University of Geneva, Geneva, Switzerland
Sara Seitun

³Interventional Radiology Department San Martino Hospital, University of Genova, Genoa, Italy
Manrico Balbi

¹Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
Claudio Brunelli

¹Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
Antonello Parodi

¹Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
Alessio Nencioni

⁴First Medical Clinic, Laboratory of Phagocyte Physiopathology and Inflammation, Department of Internal Medicine, University of Genoa, Genoa, Italy
Nicolas Vuilleumier

⁵Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, Switzerland

⁶Department of Human Protein Science, Geneva Faculty of Medicine, Geneva, Switzerland
Fabrizio Montecucco

²Division of Cardiology, Department of Internal Medicine, Foundation for Medical researches, University of Geneva, Geneva, Switzerland

⁴First Medical Clinic, Laboratory of Phagocyte Physiopathology and Inflammation, Department of Internal Medicine, University of Genoa, Genoa, Italy

Abstract

Summary

Several studies have been carried out on vulnerable plaque as the main culprit for ischaemic cardiac events. Historically, the most important diagnostic technique for studying coronary atherosclerotic disease was to determine the residual luminal diameter by angiographic measurement of the stenosis. However, it has become clear that vulnerable plaque rupture as well as thrombosis, rather than stenosis, triggers most acute ischaemic events and that the quantification of risk based merely on severity of the arterial stenosis is not sufficient. In the last decades, substantial progresses have been made on optimisation of techniques detecting the arterial wall morphology, plaque composition and inflammation. To date, the use of a single technique is not recommended to precisely identify the progression of the atherosclerotic process in human beings. In contrast, the integration of data that can be derived from multiple methods might improve our knowledge about plaque destabilisation. The aim of this narrative review is to update evidence on the accuracy of the currently available non-invasive and invasive imaging techniques in identifying components and morphologic characteristics associated with coronary plaque vulnerability.

Keywords

Vulnerable plaque - atherosclerosis - imaging - nuclear medicine - coronary arteries

Full Text

References

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