Calls for Vulnerable Plaque Research

Stabilizing vulnerable plaques could cut need for invasive treatment

(RxWiki News) Hoping to spark action, the European Society of Cardiology Working Group of Atherosclerosis and Vascular Biology has published a position paper to bring fatty plaques into the forefront, as well as the need for more therapies to reduce that accumulation.

That paper, which was published in Thrombosis and Haemostasis, requests the development of better diagnostics and treatments. It also calls for a noninvasive imaging tool and additional study into the causes of plaque rupture, which occurs when that fatty build up bursts and can lead to problems such as heart attacks or strokes.

"There is currently no way to identify a plaque rupture without an autopsy."

Stabilizing these vulnerable plaques offers a basic approach to preventing adverse heart events. A vulnerable plaque is a collection of white blood cells and lipids in an artery wall that is unstable and can produce major cardiovascular problems. Those fatty deposits in artery walls are prone to rupture and may cause cardiovascular events. In many cases there is a thin fibrous cap and a large and soft lipid pool under the cap.

Several statin trials for secondary prevention have reported a reduction in cardiovascular events. Ylä-Herttuala, a working member of the group from the University of Eastern Finland, said that introducing the stabilization of vulnerable plaques as part of secondary prevention would mean that half of all coronary events could be prevented. Their introduction also would significantly reduce the need for invasive treatments.

Plaque stabilization was introduced to explain how acute coronary events could be reduced by lipid lowering therapy without accompanying regression of coronary atherosclerosis seen on angiography, researchers said.

Some of the motivation for producing the working paper was to provide general clinicians with greater guidance, especially because family physicians can become concerned that patients treated with statins for several years have seen no change on angiograms which could prompt a dangerous decision to stop life saving treatment.

In the paper, researchers also asked for more translational research into imaging, biomarkers and the development of new treatments.

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Review Date: 
June 15, 2011