SHAPE Society

1. •Prevention of
heart attacks must
be the primary
goal.
Treatment should
be regarded as
“locking the
barn door
after the
horse is
stolen”
Eugene Braunwald
Drug
Eluting
Stent
Lock!

2. Introducing
The Vulnerable Patient Consensus Statement
Published in

3. Circulation Journal Vol108, No14; October 7, 2003

4. Naghavi et al. Circulation. 2003;108:1664
The most common type

5. Underlying Pathologies of "Culprit" Coronary Lesions
Circulation. 2003;108:1664
Ruptured plaques ( ~ 70%)
• Stenotic ( 20%)
• Nonstenotic ( 50%)
Nonruptured plaques ( ~ 30%)
• Erosion
• Calcified nodule
• Others/Unknown
*Adapted from Falk and associates,6 Davies,7 and Virmani and colleagues.7

10. From Davies and Falk
A typical rupture-prone vulnerable plaque