Preventing future acute coronary events:Can we find and treat either the vulnerable plaque or the vulnerable, high risk patient?

Abstract

Acute myocardial infarction (AMI) and sudden cardiac death (SCD) contribute to the leading cause of mortality for adults in the United States – cardiovascular disease.  Over the last 3 decades, there have been tremendous improvements in our ability to: rapidly detect (eg. Troponin utilization) and treat acute coronary syndromes (eg.new medications, percutaneous coronary intervention), lower cardiovascular risk (eg. statins) and standardize cardiovascular care through widely available guideline-directed medical therapies.  Nevertheless, according to the American Heart Association, in 2010 there were still an estimated 915,000 new or recurrent AMIs and 278,000 SCD events.¹So this begs the question, what more can we do to prevent devastating future acute coronary events?