Identification of Vulnerable Atherosclerotic Plaques

The rupture of a vulnerable atherosclerotic plaque usually underlies acute coronary syndroınes. Early identification of such a plaque is essential for the prevention from subsequent elinical events. The methods for identifying vulnerable plaques should demonstrate both the intdnsic features- leading to rupture i.e. increased lipid content, thin fıbrous cap and increased inflammatory activity and, systemic tendeney for the plaque progression. Therefore, these methods for the detection of vulnerable plaques can be classified into two groups: l.Locally identifying methods, 2.Systeınic markers Türk Kardiyol Dem Arş 2001; 29: 330-333 Most of the locally identi fy ing methods are invasive. Intravascular ultrasound and coronary angioscopy are the leading methods. Electron beam computed tomography (EBCT) which calculates the vascular calcification score, magnetic resonance imaging (MRI) techniques which help in characterization of the plaque structure and thermographic methods d em a n s ır a tin g the increased vascular heat production due to i n fl a mın ato ry activity are other promising ın ethods. Systemic markers which reflect the increased and ongo ing inflaınmatory activity ineJude C-reactive protein, serum aın ilo id A, interleukin 6, activated protein C res istance and seropositivity for chlamydia pneumonia. The best approach should probably be the evaluation of the information obtained from locally identifying methods in the light of systemic markers and risk factors.