From 2000 to 2005, CIMIT was a leader in initiating a vulnerable plaque detection program to facilitate cross-institutional, multidisciplinary efforts to solve the coronary problem. The program was successful in stimulating collaborations that increased scientific activity and led to important advances such as ways to detect plaques.
In the decade since the conclusion of the initial program, there has been significant progress across multiple disciplines capable of contributing to both detection and, more recently, treatment of vulnerable plaques. Serum risk markers, genetic testing, non-invasive imaging, invasive imaging, pharmacologic therapy, and local stenting therapy have all improved.
Additionally, the concept of the “vulnerable patient” has emerged, as atherosclerosis is a systemic disease present in multiple locations. While a vulnerable plaque can be treated with local therapy, the systemic aspect of the disease is most amenable to pharmacologic therapy. Powerful new agents such as PCSK9 inhibitors are available, but are costly. However, their cost-effectiveness improves if used in vulnerable patients.
Today, we see that there is still work to be done. There is a critical need to build upon what we have learned and continue to work to reduce the burden of CAD which is why we have launched VP2, our new Vulnerable Plaque and Patient initiative.