Pozo E, Agudo-Quilez P, Rojas-González A, Alvarado T, Olivera MJ, Jiménez-Borreguero LJ, Alfonso F. Noninvasive diagnosis of vulnerable coronary plaque. World J Cardiol 2016; 8(9): 520-533 [PMID: 27721935 DOI: 10.4330/wjc.v8.i9.520]
Corresponding Author of This Article
Fernando Alfonso, MD, PhD, Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006 Madrid, Spain. falf@hotmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Sep 26, 2016; 8(9): 520-533 Published online Sep 26, 2016. doi: 10.4330/wjc.v8.i9.520
Noninvasive diagnosis of vulnerable coronary plaque
Eduardo Pozo, Pilar Agudo-Quilez, Antonio Rojas-González, Teresa Alvarado, María José Olivera, Luis Jesús Jiménez-Borreguero, Fernando Alfonso
Eduardo Pozo, Pilar Agudo-Quilez, Antonio Rojas-González, Teresa Alvarado, Luis Jesús Jiménez-Borreguero, Fernando Alfonso, Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, 28006 Madrid, Spain
María José Olivera, Radiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, 28006 Madrid, Spain
Luis Jesús Jiménez-Borreguero, Centro Nacional de Investigaciones Cardiovasculares, 28029 Madrid, Spain
Author contributions: Pozo E performed the majority of the writing and prepared the figures and tables; Agudo-Quilez P, Rojas-González A and Alvarado T assisted in the bibliographic search; Olivera MJ and Jiménez-Borreguero LJ reviewed the final version of the manuscript; Alfonso F coordinated the writing of the paper.
Conflict-of-interest statement: No conflict of interests needs to be declared by any of the authors who contributed to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fernando Alfonso, MD, PhD, Cardiology Department, Hospital Universitario de La Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle de Diego León, 62, 28006 Madrid, Spain. falf@hotmail.com
Telephone: +34-91-5202272 Fax: +34-91-5202201
Received: April 29, 2016 Peer-review started: May 3, 2016 First decision: June 17, 2016 Revised: July 8, 2016 Accepted: July 20, 2016 Article in press: July 22, 2016 Published online: September 26, 2016
Abstract
Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease. For this reason, screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine. Necropsy studies have described histopathological changes associated with the development of acute coronary events. In this regard, thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature. Hence, many imaging techniques, such as coronary computed tomography, cardiac magnetic resonance or positron emission tomography, have tried to detect noninvasively these histomorphological characteristics with different approaches. In this article, we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.
Core tip: Noninvasive diagnosis of vulnerable coronary plaque has become of major interest in preventive cardiology. Certain histological features have been related with an increased risk of plaque rupture. Coronary computed tomography has been largely used for this aim, and some lesion characteristics have been consistently associated with acute coronary syndrome in several studies. Moreover, a growing body of evidence suggests the potential role of cardiac magnetic resonance and positron emission tomography in high-risk lesion detection. These promising results should be put in perspective to select the high-risk population that may benefit the most from the use of coronary vulnerable plaque imaging screening.
