Evolving concepts of the vulnerable atherosclerotic plaque and the vulnerable patient: implications for patient care and future research

Summary

This 2022 narrative review in Nature Reviews Cardiology synthesises contemporary understanding of atherosclerotic plaque vulnerability and the broader concept of the vulnerable patient. The authors discuss how advances in imaging and biomarker science have refined identification of high-risk lesions and populations, with implications for preventive cardiology, acute coronary syndrome management, and therapeutic development. The review appears to argue that integrated assessment of both plaque and patient characteristics is essential for precision risk stratification and personalised treatment strategies.

UK applicability

The clinical frameworks and risk-stratification concepts discussed are applicable to UK cardiovascular practice and NHS prevention programmes, particularly in refining secondary prevention strategies and informing commissioning of advanced cardiac imaging modalities in high-risk populations.

Key measures

Plaque morphology and composition; clinical and demographic risk factors; biomarkers of plaque instability; patient-level risk stratification

Outcomes reported

The paper reviews evolving concepts of vulnerable atherosclerotic plaques and vulnerable patient phenotypes, examining how identification of high-risk individuals and lesions informs cardiovascular clinical management and future research directions.

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