The document summarizes sessions from the European Society of Cardiology conference that focused on vulnerable plaque. Several sessions discussed ongoing research into the mechanisms of plaque inflammation and new markers of vulnerability. Emerging diagnostic techniques for detecting vulnerable plaque, such as thermography and elastography, were presented. The cardiology field is awaiting large clinical studies to evaluate the predictive value of these new diagnostic devices and provide guidance on risk stratification and treatment. The field of vulnerable plaque research is rapidly expanding and increasingly elucidating the underlying mechanisms of vulnerability.

1. Editorial Slides
VP Watch – September 4, 2002 - Volume 2, Issue 35
Vulnerable Plaque in ESC 2002
Berlin, Germany; August 31 – September 4, 2002

2.  In the past few days vulnerable
plaque was the focus of several
hot scientific sessions at the
Congress of European Society of
Cardiology in Berlin.

3.  Abundance of basic investigations related to
underlying mechanisms involved in plaque
inflammation, new markers of plaque
vulnerability, along with clinical topics related to
detection of vulnerable plaque particularly live case
presentations of emerging diagnostic techniques
such as thermography and elastography, all have
made ESC2002 an important event for the rapidly
growing field of vulnerable plaque.

4.  The world of cardiology is now impatiently
looking forward to the results of large clinical
studies in which the predictive values of the
emerging diagnostic devices are evaluated.
 Reproducible and validated data from such
trials may provide new guidelines for risk
stratification and management of patients at
risk of future coronary events.

5.  Selected sessions related to VP council
of biology:
 Endothelial dysfunction: new targets?
 Gene therapy in coronary and myoardial disease
 Genetic in atherosclerosis
 Modulation of atherosclerotic plaque inflammation
 Molecular studies in atherosclerosis
 New cardiac markers
 Inflammatory injury of the vessel wall
 Inflammation in atherosclerosis
 Oxidation and atherosclerosis
 Predictors of atherosclerosis
 Genetic in atherosclerosis
 Gene polymorphism in coronary artery disease
 Lipids and atherosclerosis

6.  Selected sessions related to VP council of
detection:
 Characterization of vulnerable plaque by heat, elasticity, or
morphology
 Cardiac computed tomography: something new on the horizon?
 Imaging the coronary artery: are the new techniques competitors
are adjuncts to angiography?
 New trends in imaging
 Imaging of atherosclerosis
 Magnetic resonance imaging: what’s new?
 Lesion severity: our eyes are not good enough!

7.  Selected sessions related to VP council of
treatment:
 Carotid stenting
 Coronary revascularization: needle or knife?
 Drug eluting stents: are they still holding their promise?
 Drug eluting stents: options beyond sirolimus?
 Effects of new and established lipid-lowering drugs
 Non-lipid-lowering effects of statins
 Percutaneous coronary intervention: variations in stenting, cutting,
and spotting
 We are still on the way: drug eluting and coated stents
 Restenosis and genetics
 Growth factor and cell proliferation in atherosclerosis
 Brachytherapy, coated stents

8.  Selected sessions related to VP council of
pathology:
 Inflammatory injury of the vessel wall
 Infection in atherosclerosis
 Selected sessions related to VP council of
thrombosis:
 Thrombosis – endothelial function
 Young Investigators' Award Session (Basic Science)

9.  Selected sessions related to VP council of animal
models:
 Molecular mechanisms of atherosclerosis from mouse to man
 Animal models in atherosclerosis
 Selected sessions related to VP council of
epidemiology:
 Atherosclerosis and coronary heart disease
 Management of patients at risk: risk stratification and
treatment for the prevention of cardiovascular disease

10. Conclusion
 The field of vulnerable plaque is rapidly
expanding.
 The underlying mechanisms of plaque
vulnerability are increasingly being elucidated.
 New markers of patients vulnerability are
discovered.
 Emerging VP detection technologies are
impatiently called for clinical trials.

11. Questions:
• How long from now do you expect to see the
new VP detection methods widely available in
cath-labs?
– See VP.org Poll of the Week for more