FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 343:915-922 September 28, 2000 Number 13 Next

	Full Text PDF Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Acute myocardial infarction is believed to be caused by rupture of an unstable coronary-artery plaque that appears as a single lesion on angiography. However, plaque instability might be caused by pathophysiologic processes, such as inflammation, that exert adverse effects throughout the coronary vasculature and that therefore result in multiple unstable lesions.

Methods To document the presence of multiple unstable plaques in patients with acute myocardial infarction and determine their influence on outcome, we analyzed angiograms from 253 patients for complex coronary plaques characterized by thrombus, ulceration, plaque irregularity, and impaired flow.

Results Single complex coronary plaques were identified in 153 patients (60.5 percent) and multiple complex plaques in the other 100 patients (39.5 percent). As compared with patients with single complex plaques, those with multiple complex plaques were less likely to undergo primary angioplasty (86.0 percent vs. 94.8 percent, P=0.03) and more commonly required urgent bypass surgery (27.0 percent vs. 5.2 percent, P0.001). During the year after myocardial infarction, the presence of multiple complex plaques was associated with an increased incidence of recurrent acute coronary syndromes (19.0 percent vs. 2.6 percent, P0.001); repeated angioplasty (32.0 percent vs. 12.4 percent, P0.001), particularly of non–infarct-related lesions (17.0 percent vs. 4.6 percent, P0.001); and coronary-artery bypass graft surgery (35.0 percent vs. 11.1 percent, P0.001).

Conclusions Patients with acute myocardial infarction may harbor multiple complex coronary plaques that are associated with adverse clinical outcomes. Plaque instability may be due to a widespread process throughout the coronary vessels, which may have implications for the management of acute ischemic heart disease.

Source Information

From the Division of Cardiology, William Beaumont Hospital, Royal Oak, Mich. Presented in part in abstract form at the Scientific Sessions of the American Heart Association, Atlanta, November 7–10, 1999.

Address reprint requests to Dr. Goldstein at the Division of Cardiology, William Beaumont Hospital, 3601 W. 13 Mile Rd., Royal Oak, MI 48073-6769, or at jgoldstein{at}beaumont.edu.

Full Text of this Article

This article has been cited by other articles:

• Chiou, K-R, Huang, W-C, Peng, N-J, Huang, Y-L, Hsiao, S-H, Chen, K-H, Wu, M-T (2009). Dual-phase multi-detector computed tomography assesses jeopardised and infarcted myocardium subtending infarct-related artery early after acute myocardial infarction. Heart 95: 1495-1501 [Abstract] [Full Text]  
• Goldstein, J. A. (2009). Coronary plaque characterization by computed tomographic angiography: present promise and future hope.. J Am Coll Cardiol Img 2: 161-163 [Full Text]  
• Pundziute, G., Schuijf, J. D., Jukema, J. W., Decramer, I., Sarno, G., Vanhoenacker, P. K., Boersma, E., Reiber, J. H.C., Schalij, M. J., Wijns, W., Bax, J. J. (2008). Evaluation of plaque characteristics in acute coronary syndromes: non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis. Eur Heart J 29: 2373-2381 [Abstract] [Full Text]  
• Gardner, C. M., Tan, H., Hull, E. L., Lisauskas, J. B., Sum, S. T., Meese, T. M., Jiang, C., Madden, S. P., Caplan, J. D., Burke, A. P., Virmani, R., Goldstein, J., Muller, J. E. (2008). Detection of lipid core coronary plaques in autopsy specimens with a novel catheter-based near-infrared spectroscopy system.. J Am Coll Cardiol Img 1: 638-648 [Abstract] [Full Text]  
• Young, J. J. (2008). Detection of vulnerable coronary artery plaques: lesion level risk assessment within the coronary arterial tree?. J Am Coll Cardiol Img 1: 649-651 [Full Text]  
• Dodd, J. D., Rieber, J., Pomerantsev, E., Chaithiraphan, V., Achenbach, S., Moreiras, J. M., Abbara, S., Hoffmann, U., Brady, T. J., Cury, R. C. (2008). Quantification of Nonculprit Coronary Lesions: Comparison of Cardiac 64-MDCT and Invasive Coronary Angiography. Am. J. Roentgenol. 191: 432-438 [Abstract] [Full Text]  
• Duerinckx, A. J. (2008). The Nonculprit Coronary Lesion as Seen by Coronary CT Angiography: What Should We Be Looking For?. Am. J. Roentgenol. 191: 439-440 [Full Text]  
• Biasucci, L. M., Leo, M., De Maria, G. L. (2008). Local and Systemic Mechanisms of Plaque Rupture. ANGIOLOGY 59: 73S-76S [Abstract]  
• Foglieni, C., Maisano, F., Dreas, L., Giazzon, A., Ruotolo, G., Ferrero, E., Li Volsi, L., Coli, S., Sinagra, G., Zingone, B., Alfieri, O., Becker, A. E., Maseri, A. (2008). Mild inflammatory activation of mammary arteries in patients with acute coronary syndromes. Am. J. Physiol. Heart Circ. Physiol. 294: H2831-H2837 [Abstract] [Full Text]  
• Caymaz, H. O., Yuksel, G. (2008). Fate of Incidental, Asymptomatic Lesions Discovered During Percutaneous Coronary Intervention. ANGIOLOGY 59: 193-197 [Abstract]  
• Bunch, T. J., Rihal, C. S., Gumina, R. J., Cooper, L., Caplice, N. M. (2008). Progression of Nonculprit Plaque Stenosis Following Successful Percutaneous Intervention. ANGIOLOGY 59: 236-239 [Abstract]  
• Spagnoli, L. G., Bonanno, E., Sangiorgi, G., Mauriello, A. (2007). Role of Inflammation in Atherosclerosis. JNM 48: 1800-1815 [Abstract] [Full Text]  
• Sabeti, S., Schlager, O., Exner, M., Mlekusch, W., Amighi, J., Dick, P., Maurer, G., Huber, K., Koppensteiner, R., Wagner, O., Minar, E., Schillinger, M. (2007). Progression of Carotid Stenosis Detected by Duplex Ultrasonography Predicts Adverse Outcomes in Cardiovascular High-Risk Patients. Stroke 38: 2887-2894 [Abstract] [Full Text]  
• Kubo, T., Imanishi, T., Takarada, S., Kuroi, A., Ueno, S., Yamano, T., Tanimoto, T., Matsuo, Y., Masho, T., Kitabata, H., Tsuda, K., Tomobuchi, Y., Akasaka, T. (2007). Assessment of Culprit Lesion Morphology in Acute Myocardial Infarction: Ability of Optical Coherence Tomography Compared With Intravascular Ultrasound and Coronary Angioscopy. J Am Coll Cardiol 50: 933-939 [Abstract] [Full Text]  
• Serruys, P. W., Garcia-Garcia, H. M., Regar, E. (2007). From Postmortem Characterization to the In Vivo Detection of Thin-Capped Fibroatheromas: The Missing Link Toward Percutaneous Treatment: What If Diogenes Would Have Found What He Was Looking For?. J Am Coll Cardiol 50: 950-952 [Full Text]  
• Cheruvu, P. K., Finn, A. V., Gardner, C., Caplan, J., Goldstein, J., Stone, G. W., Virmani, R., Muller, J. E. (2007). Frequency and Distribution of Thin-Cap Fibroatheroma and Ruptured Plaques in Human Coronary Arteries: A Pathologic Study. J Am Coll Cardiol 50: 940-949 [Abstract] [Full Text]  
• Sorajja, P., Gersh, B. J., Cox, D. A., McLaughlin, M. G., Zimetbaum, P., Costantini, C., Stuckey, T., Tcheng, J. E., Mehran, R., Lansky, A. J., Grines, C. L., Stone, G. W. (2007). Impact of multivessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Eur Heart J 28: 1709-1716 [Abstract] [Full Text]  
• Saam, T., Hatsukami, T. S., Takaya, N., Chu, B., Underhill, H., Kerwin, W. S., Cai, J., Ferguson, M. S., Yuan, C. (2007). The Vulnerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment. Radiology 244: 64-77 [Abstract] [Full Text]  
• Grad, E., Golomb, M., Mor-Yosef, I., Koroukhov, N., Lotan, C., Edelman, E. R., Danenberg, H. D. (2007). Transgenic expression of human C-reactive protein suppresses endothelial nitric oxide synthase expression and bioactivity after vascular injury. Am. J. Physiol. Heart Circ. Physiol. 293: H489-H495 [Abstract] [Full Text]  
• Spagnoli, L. G., Pucci, S., Bonanno, E., Cassone, A., Sesti, F., Ciervo, A., Mauriello, A. (2007). Persistent Chlamydia pneumoniae Infection of Cardiomyocytes Is Correlated with Fatal Myocardial Infarction. Am. J. Pathol. 170: 33-42 [Abstract] [Full Text]  
• Mazzadi, A. N., Andre-Fouet, X., Costes, N., Croisille, P., Revel, D., Janier, M. F. (2006). Mechanisms leading to reversible mechanical dysfunction in severe CAD: alternatives to myocardial stunning. Am. J. Physiol. Heart Circ. Physiol. 291: H2570-H2582 [Abstract] [Full Text]  
• Waxman, S., Ishibashi, F., Muller, J. E. (2006). Detection and Treatment of Vulnerable Plaques and Vulnerable Patients: Novel Approaches to Prevention of Coronary Events. Circulation 114: 2390-2411 [Full Text]  
• Van De Graaff, E., Dutta, M., Das, P., Shry, E. A., Frederick, P. D., Blaney, M., Pasta, D. J., Steinhubl, S. R. (2006). Early Coronary Revascularization Diminishes the Risk of Ischemic Stroke With Acute Myocardial Infarction. Stroke 37: 2546-2551 [Abstract] [Full Text]  
• Hofmann, R., Niessner, A., Kypta, A., Steinwender, C., Kammler, J., Kerschner, K., Grund, M., Leisch, F., Huber, K. (2006). Risk Score for Peri-Interventional Complications of Carotid Artery Stenting. Stroke 37: 2557-2561 [Abstract] [Full Text]  
• Burke, A. P., Joner, M., Virmani, R. (2006). IVUS-VH: a predictor of plaque morphology?. Eur Heart J 27: 1889-1890 [Full Text]  
• Suzuki, M., Saito, M., Nagai, T., Saeki, H., Kazatani, Y. (2006). Systemic Versus Coronary Levels of Inflammation in Acute Coronary Syndromes. ANGIOLOGY 57: 459-463 [Abstract]  
• Bloomgarden, Z. T. (2006). Third Annual World Congress on the Insulin Resistance Syndrome: Atherothrombotic disease. Diabetes Care 29: 1973-1980 [Full Text]  
• Elesber, A. A., Conover, C. A., Denktas, A. E., Lennon, R. J., Holmes, D. R. Jr, Overgaard, M. T., Christiansen, M., Oxvig, C., Lerman, L. O., Lerman, A. (2006). Prognostic value of circulating pregnancy-associated plasma protein levels in patients with chronic stable angina. Eur Heart J 27: 1678-1684 [Abstract] [Full Text]  
• Ohtani, T., Ueda, Y., Mizote, I., Oyabu, J., Okada, K., Hirayama, A., Kodama, K. (2006). Number of Yellow Plaques Detected in a Coronary Artery Is Associated With Future Risk of Acute Coronary Syndrome: Detection of Vulnerable Patients by Angioscopy. J Am Coll Cardiol 47: 2194-2200 [Abstract] [Full Text]  
• Stone, G. W., Aronow, H. D. (2006). Long-term Care After Percutaneous Coronary Intervention: Focus on the Role of Antiplatelet Therapy. Mayo Clin Proc. 81: 641-652 [Abstract] [Full Text]  
• Hoffmann, U., Moselewski, F., Nieman, K., Jang, I.-K., Ferencik, M., Rahman, A. M., Cury, R. C., Abbara, S., Joneidi-Jafari, H., Achenbach, S., Brady, T. J. (2006). Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography. J Am Coll Cardiol 47: 1655-1662 [Abstract] [Full Text]  
• DeMaria, A. N., Narula, J., Mahmud, E., Tsimikas, S. (2006). Imaging vulnerable plaque by ultrasound.. J Am Coll Cardiol 47: C32-C39 [Abstract] [Full Text]  
• Stamper, D., Weissman, N. J., Brezinski, M. (2006). Plaque Characterization With Optical Coherence Tomography.. J Am Coll Cardiol 47: C69-C79 [Abstract] [Full Text]  
• Escolar, E., Weigold, G., Fuisz, A., Weissman, N. J. (2006). New imaging techniques for diagnosing coronary artery disease.. CMAJ 174: 487-495 [Abstract] [Full Text]  
• De Palma, R., Del Galdo, F., Abbate, G., Chiariello, M., Calabro, R., Forte, L., Cimmino, G., Papa, M. F., Russo, M. G., Ambrosio, G., Giombolini, C., Tritto, I., Notaristefano, S., Berrino, L., Rossi, F., Golino, P. (2006). Patients With Acute Coronary Syndrome Show Oligoclonal T-Cell Recruitment Within Unstable Plaque: Evidence for a Local, Intracoronary Immunologic Mechanism. Circulation 113: 640-646 [Abstract] [Full Text]  
• Toutouzas, K., Drakopoulou, M., Mitropoulos, J., Tsiamis, E., Vaina, S., Vavuranakis, M., Markou, V., Bosinakou, E., Stefanadis, C. (2006). Elevated Plaque Temperature in Non-Culprit De Novo Atheromatous Lesions of Patients With Acute Coronary Syndromes. J Am Coll Cardiol 47: 301-306 [Abstract] [Full Text]  
• Sdringola, S., Loghin, C., Boccalandro, F., Gould, K. L. (2006). Mechanisms of Progression and Regression of Coronary Artery Disease by PET Related to Treatment Intensity and Clinical Events at Long-Term Follow-up. JNM 47: 59-67 [Abstract] [Full Text]  
• Rodriguez-Granillo, G. A., Garcia-Garcia, H. M., Mc Fadden, E. P., Valgimigli, M., Aoki, J., de Feyter, P., Serruys, P. W. (2005). In Vivo Intravascular Ultrasound-Derived Thin-Cap Fibroatheroma Detection Using Ultrasound Radiofrequency Data Analysis. J Am Coll Cardiol 46: 2038-2042 [Abstract] [Full Text]  
• Smith, E J, Mathur, A, Rothman, M T (2005). Recent advances in primary percutaneous intervention for acute myocardial infarction. Heart 91: 1533-1536 [Full Text]  
• Ince, H., Petzsch, M., Kleine, H. D., Schmidt, H., Rehders, T., Korber, T., Schumichen, C., Freund, M., Nienaber, C. A. (2005). Preservation From Left Ventricular Remodeling by Front-Integrated Revascularization and Stem Cell Liberation in Evolving Acute Myocardial Infarction by Use of Granulocyte-Colony-Stimulating Factor (FIRSTLINE-AMI). Circulation 112: 3097-3106 [Abstract] [Full Text]  
• Bartnik, M., Malmberg, K., Ryden, L. (2005). Management of patients with type 2 diabetes after acute coronary syndromes. Diabetes and Vascular Disease Research 2: 144-154 [Abstract]  
• Zimarino, M., Calafiore, A. M., De Caterina, R. (2005). Complete myocardial revascularization: between myth and reality. Eur Heart J 26: 1824-1830 [Abstract] [Full Text]  
• Biasucci, L M, Giubilato, G, Graziani, F, Piro, M (2005). CRP is or is not a reliable marker of ischaemic heart disease?. Lupus 14: 752-755 [Abstract]  
• Zimarino, M., De Caterina, R. (2005). Complete myocardial revascularization: between myth and reality: reply. Eur Heart J 26: 1810-1811 [Full Text]  
• Valgimigli, M., Agostoni, P., Biondi Zoccai, G. G.L. (2005). Complete myocardial revascularization: between myth and reality. Eur Heart J 26: 1809-1810 [Full Text]  
• Figueras, J, Pena, C, Soler-Soler, J (2005). Thirty day prognosis of patients with acute pulmonary oedema complicating acute coronary syndromes. Heart 91: 889-893 [Abstract] [Full Text]  
• Libby, P., Theroux, P. (2005). Pathophysiology of Coronary Artery Disease. Circulation 111: 3481-3488 [Abstract] [Full Text]  
• Mauriello, A., Sangiorgi, G., Fratoni, S., Palmieri, G., Bonanno, E., Anemona, L., Schwartz, R. S., Spagnoli, L. G. (2005). Diffuse and Active Inflammation Occurs in Both Vulnerable and Stable Plaques of the Entire Coronary Tree: A Histopathologic Study of Patients Dying of Acute Myocardial Infarction. J Am Coll Cardiol 45: 1585-1593 [Abstract] [Full Text]  
• Tanaka, A., Shimada, K., Sano, T., Namba, M., Sakamoto, T., Nishida, Y., Kawarabayashi, T., Fukuda, D., Yoshikawa, J. (2005). Multiple Plaque Rupture and C-Reactive Protein in Acute Myocardial Infarction. J Am Coll Cardiol 45: 1594-1599 [Abstract] [Full Text]  
• Libby, P. (2005). Act Local, Act Global: Inflammation and the Multiplicity of "Vulnerable" Coronary Plaques. J Am Coll Cardiol 45: 1600-1602 [Full Text]  
• Schillinger, M., Exner, M., Mlekusch, W., Sabeti, S., Amighi, J., Nikowitsch, R., Timmel, E., Kickinger, B., Minar, C., Pones, M., Lalouschek, W., Rumpold, H., Maurer, G., Wagner, O., Minar, E. (2005). Inflammation and Carotid Artery--Risk for Atherosclerosis Study (ICARAS). Circulation 111: 2203-2209 [Abstract] [Full Text]  
• Takano, M., Inami, S., Ishibashi, F., Okamatsu, K., Seimiya, K., Ohba, T., Sakai, S., Mizuno, K. (2005). Angioscopic follow-up study of coronary ruptured plaques in nonculprit lesions. J Am Coll Cardiol 45: 652-658 [Abstract] [Full Text]  
• Ambrose, J. A., D'Agate, D. J. (2005). Plaque rupture and intracoronary thrombus in nonculprit vessels: An eyewitness account. J Am Coll Cardiol 45: 659-660 [Full Text]  
• Lerman, A., Zeiher, A. M. (2005). Endothelial Function: Cardiac Events. Circulation 111: 363-368 [Full Text]  
• Monaco, C., Rossi, E., Milazzo, D., Citterio, F., Ginnetti, F., D'Onofrio, G., Cianflone, D., Crea, F., Biasucci, L. M., Maseri, A. (2005). Persistent systemic inflammation in unstable angina is largely unrelated to the atherothrombotic burden. J Am Coll Cardiol 45: 238-243 [Abstract] [Full Text]  
• Vetrovec, G. W. (2005). Optimizing Percutaneous Coronary Intervention Outcomes: The Next Steps. Circulation 111: 125-126 [Full Text]  
• Glaser, R., Selzer, F., Faxon, D. P., Laskey, W. K., Cohen, H. A., Slater, J., Detre, K. M., Wilensky, R. L. (2005). Clinical Progression of Incidental, Asymptomatic Lesions Discovered During Culprit Vessel Coronary Intervention. Circulation 111: 143-149 [Abstract] [Full Text]  
• Rioufol, G., Gilard, M., Finet, G., Ginon, I., Boschat, J., Andre-Fouet, X. (2004). Evolution of Spontaneous Atherosclerotic Plaque Rupture With Medical Therapy: Long-Term Follow-Up With Intravascular Ultrasound. Circulation 110: 2875-2880 [Abstract] [Full Text]  
• Lovett, J.K., Gallagher, P.J., Hands, L.J., Walton, J., Rothwell, P.M. (2004). Histological Correlates of Carotid Plaque Surface Morphology on Lumen Contrast Imaging. Circulation 110: 2190-2197 [Abstract] [Full Text]  
• Madjid, M., Zarrabi, A., Litovsky, S., Willerson, J. T., Casscells, W. (2004). Finding Vulnerable Atherosclerotic Plaques: Is It Worth the Effort?. Arterioscler. Thromb. Vasc. Bio. 24: 1775-1782 [Abstract] [Full Text]  
• Fernandez-Aviles, F., San Roman, J. A., Garcia-Frade, J., Fernandez, M. E., Penarrubia, M. J., de la Fuente, L., Gomez-Bueno, M., Cantalapiedra, A., Fernandez, J., Gutierrez, O., Sanchez, P. L., Hernandez, C., Sanz, R., Garcia-Sancho, J., Sanchez, A. (2004). Experimental and Clinical Regenerative Capability of Human Bone Marrow Cells After Myocardial Infarction. Circ. Res. 95: 742-748 [Abstract] [Full Text]  
• Zouridakis, E., Avanzas, P., Arroyo-Espliguero, R., Fredericks, S., Kaski, J. C. (2004). Markers of Inflammation and Rapid Coronary Artery Disease Progression in Patients With Stable Angina Pectoris. Circulation 110: 1747-1753 [Abstract] [Full Text]  
• Okazaki, S., Yokoyama, T., Miyauchi, K., Shimada, K., Kurata, T., Sato, H., Daida, H. (2004). Early Statin Treatment in Patients With Acute Coronary Syndrome: Demonstration of the Beneficial Effect on Atherosclerotic Lesions by Serial Volumetric Intravascular Ultrasound Analysis During Half a Year After Coronary Event: The ESTABLISH Study. Circulation 110: 1061-1068 [Abstract] [Full Text]  
• Hong, M.-K., Mintz, G. S., Lee, C. W., Kim, Y.-H., Lee, S.-W., Song, J.-M., Han, K.-H., Kang, D.-H., Song, J.-K., Kim, J.-J., Park, S.-W., Park, S.-J. (2004). Comparison of Coronary Plaque Rupture Between Stable Angina and Acute Myocardial Infarction: A Three-Vessel Intravascular Ultrasound Study in 235 Patients. Circulation 110: 928-933 [Abstract] [Full Text]  
• Avanzas, P, Arroyo-Espliguero, R, Cosin-Sales, J, Aldama, G, Pizzi, C, Quiles, J, Kaski, J C (2004). Markers of inflammation and multiple complex stenoses (pancoronary plaque vulnerability) in patients with non-ST segment elevation acute coronary syndromes. Heart 90: 847-852 [Abstract] [Full Text]  
• Abbate, A., Bonanno, E., Mauriello, A., Bussani, R., Biondi-Zoccai, G. G.L., Liuzzo, G., Leone, A. M., Silvestri, F., Dobrina, A., Baldi, F., Pandolfi, F., Biasucci, L. M., Baldi, A., Spagnoli, L. G., Crea, F. (2004). Widespread Myocardial Inflammation and Infarct-Related Artery Patency. Circulation 110: 46-50 [Abstract] [Full Text]  
• Priebe, H.-J. (2004). Triggers of perioperative myocardial ischaemia and infarction. Br J Anaesth 93: 9-20 [Abstract] [Full Text]  
• Gibson, C. M., Schomig, A. (2004). Coronary and Myocardial Angiography: Angiographic Assessment of Both Epicardial and Myocardial Perfusion. Circulation 109: 3096-3105 [Full Text]  
• Lombardo, A., Biasucci, L. M., Lanza, G. A., Coli, S., Silvestri, P., Cianflone, D., Liuzzo, G., Burzotta, F., Crea, F., Maseri, A. (2004). Inflammation as a Possible Link Between Coronary and Carotid Plaque Instability. Circulation 109: 3158-3163 [Abstract] [Full Text]  
• Luft, F. C. (2004). Cardiac Angiotensin Is Upregulated in the Hearts of Unstable Angina Patients. Circ. Res. 94: 1530-1532 [Full Text]  
• Neri Serneri, G. G., Boddi, M., Modesti, P. A., Coppo, M., Cecioni, I., Toscano, T., Papa, M. L., Bandinelli, M., Lisi, G. F., Chiavarelli, M. (2004). Cardiac Angiotensin II Participates in Coronary Microvessel Inflammation of Unstable Angina and Strengthens the Immunomediated Component. Circ. Res. 94: 1630-1637 [Abstract] [Full Text]  
• Langheinrich, A. C., Bohle, R. M., Greschus, S., Hackstein, N., Walker, G., von Gerlach, S., Rau, W. S., Holschermann, H. (2004). Atherosclerotic Lesions at Micro CT: Feasibility for Analysis of Coronary Artery Wall in Autopsy Specimens. Radiology 231: 675-681 [Abstract] [Full Text]  
• Cannon, C. P., Braunwald, E., McCabe, C. H., Rader, D. J., Rouleau, J. L., Belder, R., Joyal, S. V., Hill, K. A., Pfeffer, M. A., Skene, A. M., the Pravastatin or Atorvastatin Evaluation and Inf, (2004). Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes. NEJM 350: 1495-1504 [Abstract] [Full Text]  
• Honda, O., Sugiyama, S., Kugiyama, K., Fukushima, H., Nakamura, S., Koide, S., Kojima, S., Hirai, N., Kawano, H., Soejima, H., Sakamoto, T., Yoshimura, M., Ogawa, H. (2004). Echolucent carotid plaques predict future coronary events in patients with coronary artery disease. J Am Coll Cardiol 43: 1177-1184 [Abstract] [Full Text]  
• Leber, A. W., Knez, A., Becker, A., Becker, C., von Ziegler, F., Nikolaou, K., Rist, C., Reiser, M., White, C., Steinbeck, G., Boekstegers, P. (2004). Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: A comparative study with intracoronary ultrasound. J Am Coll Cardiol 43: 1241-1247 [Abstract] [Full Text]  
• Arroyo-Espliguero, R., Avanzas, P., Cosin-Sales, J., Aldama, G., Pizzi, C., Kaski, J. C. (2004). C-reactive protein elevation and disease activity in patients with coronary artery disease. Eur Heart J 25: 401-408 [Abstract] [Full Text]  
• Chandra, H. R., Goldstein, J. A., Choudhary, N., O'Neill, C. S., George, P. B., Gangasani, S. R., Cronin, L., Marcovitz, P. A., Hauser, A. M., O'Neill, W. W. (2004). Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation. J Am Coll Cardiol 43: 169-175 [Abstract] [Full Text]  
• Lutgens, E., van Suylen, R.-J., Faber, B. C., Gijbels, M. J., Eurlings, P. M., Bijnens, A.-P., Cleutjens, K. B., Heeneman, S., Daemen, M. J.A.P. (2003). Atherosclerotic Plaque Rupture: Local or Systemic Process?. Arterioscler. Thromb. Vasc. Bio. 23: 2123-2130 [Abstract] [Full Text]  
• Fujii, K., Kobayashi, Y., Mintz, G. S., Takebayashi, H., Dangas, G., Moussa, I., Mehran, R., Lansky, A. J., Kreps, E., Collins, M., Colombo, A., Stone, G. W., Leon, M. B., Moses, J. W. (2003). Intravascular Ultrasound Assessment of Ulcerated Ruptured Plaques: A Comparison of Culprit and Nonculprit Lesions of Patients With Acute Coronary Syndromes and Lesions in Patients Without Acute Coronary Syndromes. Circulation 108: 2473-2478 [Abstract] [Full Text]  
• Naghavi, M., Libby, P., Falk, E., Casscells, S. W., Litovsky, S., Rumberger, J., Badimon, J. J., Stefanadis, C., Moreno, P., Pasterkamp, G., Fayad, Z., Stone, P. H., Waxman, S., Raggi, P., Madjid, M., Zarrabi, A., Burke, A., Yuan, C., Fitzgerald, P. J., Siscovick, D. S., de Korte, C. L., Aikawa, M., Juhani Airaksinen, K.E., Assmann, G., Becker, C. R., Chesebro, J. H., Farb, A., Galis, Z. S., Jackson, C., Jang, I.-K., Koenig, W., Lodder, R. A., March, K., Demirovic, J., Navab, M., Priori, S. G., Rekhter, M. D., Bahr, R., Grundy, S. M., Mehran, R., Colombo, A., Boerwinkle, E., Ballantyne, C., Insull, W. Jr, Schwartz, R. S., Vogel, R., Serruys, P. W., Hansson, G. K., Faxon, D. P., Kaul, S., Drexler, H., Greenland, P., Muller, J. E., Virmani, R., Ridker, P. M, Zipes, D. P., Shah, P. K., Willerson, J. T. (2003). From Vulnerable Plaque to Vulnerable Patient: A Call for New Definitions and Risk Assessment Strategies: Part I. Circulation 108: 1664-1672 [Abstract] [Full Text]  
• Schoenhagen, P., Stone, G. W., Nissen, S. E., Grines, C. L., Griffin, J., Clemson, B. S., Vince, D. G., Ziada, K., Crowe, T., Apperson-Hanson, C., Kapadia, S. R., Tuzcu, E. M. (2003). Coronary Plaque Morphology and Frequency of Ulceration Distant From Culprit Lesions in Patients With Unstable and Stable Presentation. Arterioscler. Thromb. Vasc. Bio. 23: 1895-1900 [Abstract] [Full Text]  
• Kato, M., Dote, K., Habara, S., Takemoto, H., Goto, K., Nakaoka, K. (2003). Clinical implications of carotid artery remodeling in acute coronary syndrome: Ultrasonographic assessment of positive remodeling. J Am Coll Cardiol 42: 1026-1032 [Abstract] [Full Text]  
• Tuzcu, E. M., Schoenhagen, P. (2003). Acute coronary syndromes, plaque vulnerability,and carotid artery disease: The changing role ofatherosclerosis imaging. J Am Coll Cardiol 42: 1033-1036 [Full Text]  
• Forrester, J. S., Price, M. J., Makkar, R. R. (2003). Stem Cell Repair of Infarcted Myocardium: An Overview for Clinicians. Circulation 108: 1139-1145 [Full Text]  
• Erbel, R (2003). Spontaneous and interventional coronary microembolisation. Heart 89: 986-989 [Full Text]  
• Neri Serneri, G. G., Boddi, M., Modesti, P. A., Cecioni, I., Coppo, M., Papa, M. L., Toscano, T., Marullo, A., Chiavarelli, M. (2003). Immunomediated and Ischemia-Independent Inflammation of Coronary Microvessels in Unstable Angina. Circ. Res. 92: 1359-1366 [Abstract] [Full Text]  
• Kotani, J.-i., Mintz, G. S., Castagna, M. T., Pinnow, E., Berzingi, C. O., Bui, A. B., Pichard, A. D., Satler, L. F., Suddath, W. O., Waksman, R., Laird, J. R. Jr, Kent, K. M., Weissman, N. J. (2003). Intravascular Ultrasound Analysis of Infarct-Related and Non-Infarct-Related Arteries in Patients Who Presented With an Acute Myocardial Infarction. Circulation 107: 2889-2893 [Abstract] [Full Text]  
• Maseri, A., Fuster, V. (2003). Is There a Vulnerable Plaque?. Circulation 107: 2068-2071 [Full Text]  
• Casscells, W., Naghavi, M., Willerson, J. T. (2003). Vulnerable Atherosclerotic Plaque: A Multifocal Disease. Circulation 107: 2072-2075 [Full Text]  
• Poldermans, D., Bax, J. J., Kertai, M. D., Krenning, B., Westerhout, C. M., Schinkel, A. F.L., Thomson, I. R., Lansberg, P. J., Fleisher, L. A., Klein, J., van Urk, H., Roelandt, J. R.T.C., Boersma, E. (2003). Statins Are Associated With a Reduced Incidence of Perioperative Mortality in Patients Undergoing Major Noncardiac Vascular Surgery. Circulation 107: 1848-1851 [Abstract] [Full Text]