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Volume 14
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10.3390/jcm14051539
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Review

Perspectives in the Diagnosis, Clinical Impact, and Management of the Vulnerable Plaque

by
Alberto Alperi
1,2,†,
Paula Antuna
1,2,†,
Marcel Almendárez
1,
Rut Álvarez
1,
Raquel del Valle
1,
Isaac Pascual
1,2,3,
Daniel Hernández-Vaquero
1,2,3 and
Pablo Avanzas
1,2,3,4,*
1
Hospital Universitario Central de Asturias, Oviedo, 33011 Asturias, Spain
2
Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Asturias, Spain
3
Faculty of Medicine, University of Oviedo, 33011 Asturias, Spain
4
Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), 28046 Madrid, Spain
*
Author to whom correspondence should be addressed.
†
Both authors have contributed equally and shared first authorship of the manuscript.
J. Clin. Med. 2025, 14(5), 1539; https://doi.org/10.3390/jcm14051539
Submission received: 16 January 2025 / Revised: 18 February 2025 / Accepted: 21 February 2025 / Published: 25 February 2025
(This article belongs to the Section Cardiology)
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Abstract

Coronary artery disease is a highly prevalent disease that constitutes the leading cause of mortality worldwide. Acute coronary syndromes are the most devastating form of presentation of coronary disease, involving the acute formation of a thrombus within the coronary vessel lumen, further leading to flow limitation and diminished myocardial perfusion. Vulnerable plaques, which are characterized by thin-cap fibroatheroma, a large lipid pool, and macrophage infiltration and spotty calcification of the cap, pose a higher risk of coronary events despite not being flow-limiting. Iterations in intravascular imaging and coronary computed tomography have largely increased the ability to detect and define vulnerable plaques, and its clinical impact in early- and mid-term outcomes has been confirmed in several studies. In this review, we aimed to revise the current concept of vulnerable coronary plaque and its repercussion, to summarize the main pharmacological approaches for its management, and to provide an updated overview of the available evidence on preventive percutaneous interventional strategies in this clinical setting.
Keywords: vulnerable plaque; percutaneous coronary intervention; coronary artery disease vulnerable plaque; percutaneous coronary intervention; coronary artery disease

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MDPI and ACS Style

Alperi, A.; Antuna, P.; Almendárez, M.; Álvarez, R.; del Valle, R.; Pascual, I.; Hernández-Vaquero, D.; Avanzas, P. Perspectives in the Diagnosis, Clinical Impact, and Management of the Vulnerable Plaque. J. Clin. Med. 2025, 14, 1539. https://doi.org/10.3390/jcm14051539

AMA Style

Alperi A, Antuna P, Almendárez M, Álvarez R, del Valle R, Pascual I, Hernández-Vaquero D, Avanzas P. Perspectives in the Diagnosis, Clinical Impact, and Management of the Vulnerable Plaque. Journal of Clinical Medicine. 2025; 14(5):1539. https://doi.org/10.3390/jcm14051539

Chicago/Turabian Style

Alperi, Alberto, Paula Antuna, Marcel Almendárez, Rut Álvarez, Raquel del Valle, Isaac Pascual, Daniel Hernández-Vaquero, and Pablo Avanzas. 2025. "Perspectives in the Diagnosis, Clinical Impact, and Management of the Vulnerable Plaque" Journal of Clinical Medicine 14, no. 5: 1539. https://doi.org/10.3390/jcm14051539

APA Style

Alperi, A., Antuna, P., Almendárez, M., Álvarez, R., del Valle, R., Pascual, I., Hernández-Vaquero, D., & Avanzas, P. (2025). Perspectives in the Diagnosis, Clinical Impact, and Management of the Vulnerable Plaque. Journal of Clinical Medicine, 14(5), 1539. https://doi.org/10.3390/jcm14051539

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