This document summarizes presentations from symposia on vulnerable plaque and discusses the relationship between plaque, blood, and patients in atherothrombosis. It notes that systemic therapies may be more effective than local interventions in stabilizing plaque. Risk factors such as diabetes, smoking, and hyperlipidemia are associated with increased thrombotic risk, in part due to higher levels of tissue factor and impaired fibrinolysis. Novel antithrombotic agents that target tissue factor or downstream coagulation factors show promise in reducing acute coronary events.