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How the world dies today

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SHAPE Society

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How the world dies today

  1. 1. How the World Dies Today?
  2. 2. W.H.O
  3. 3. Everybody has atherosclerosis, the question is who has vulnerable plaque Sudden Cardiac Death Acute MI Vulnerable Plaque(s)
  4. 4. Compensatory Enlargement of Human Atherosclerotic Coronary Arteries N Engl J Med 1987 May 28;316(22):1371-5 <50% stenosis Luminal area is not endangered until more than 40% of internal elastic lamina is destructed and occupied by plaque Coronary artery disease is a disease of arterial wall disease not lumen. PositiveRemodeling <80% stenosis
  5. 5. PlaqueEruption (Volcano!)
  6. 6. Different Types of Vulnerable Plaques Major Underlying Cause of Acute Coronary Events Normal Rupture-prone Fissured Eroded Critical Stenosis Hemorrhage Naghavi et al, Cur Ath Rep 2001
  7. 7. How important is early detection of vulnerable plaque?
  8. 8. In 70% of cases the first symptom of having a vulnerable plaque is sudden death outside of hospital.
  9. 9. 1.5 million heart attacks, 6 million heart failures and 500,000 sudden deaths can be prevented if vulnerable plaque is detected and treated.
  10. 10. In search of “vulnerable patient”
  11. 11. 1,400,000 Annual Heart Attacks 140,000,000 Americans>35y Home-Based Screening Non-invasive Imaging Office-Based Screening Invasive Dx with Rx2-3 millions 40-50 millions 50-60 millions Non-invasive Home-Based Biomarkers(Glu, Chol, CRP, …) Self-Screening Questionnaire CT Calcium and Cholesterol Imaging NoninvasiveAngiography Non-InvasiveMolecular Imaging for Plaqueand Myocardium Characterization Homeand Office Based Endothelial F. Test, ECG… Intravascular Ultrasound, Thermography, OCT, NIR Spectroscopy… Home-Based, Non-Invasive, Easy and Inexpensive Non-Invasive Imaging
  12. 12. 2001 2050 Genomic Proteomic 2007 2015 2020 2040 VP Treatment Home-based VP Screening Test Heart Attack Rate Falls Below 10,000 per year Cloning Heart VP Rx as OTC and Vaccine against heart attack Eradication of Heart Attack VP Detection Mission:
  13. 13. Association for Eradication of Heart Attack www.VP.org

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