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Major focus has been placed on the identification of vulnerable plaques as a means of improving the prediction of myocardial infarction. However, this strategy has recently been questioned on the basis that the majority of these individual coronary lesions do not in fact go on to cause clinical events. Attention is, therefore, shifting to alternative imaging modalities that might provide a more complete pan-coronary assessment of the atherosclerotic disease process. These include markers of disease activity with the potential to discriminate between patients with stable burnt-out disease that is no longer metabolically active and those with active atheroma, faster disease progression, and increased risk of infarction. This review will examine how novel molecular imaging approaches can provide such assessments, focusing on inflammation and microcalcification activity, the importance of these processes to coronary atherosclerosis, and the advantages and challenges posed by these techniques.

Original publication

DOI

10.1161/CIRCRESAHA.116.307971

Type

Journal article

Journal

Circ res

Publication Date

08/07/2016

Volume

119

Pages

330 - 340

Keywords

18F-Fluorodeoxyglucose, atherosclerosis, disease progression, inflammation, myocardial infarction, Atherosclerosis, Disease Progression, Humans, Molecular Imaging, Positron-Emission Tomography, Vascular Calcification