Management of Atherosclerosis

Dear Colleagues,

Although we are living in the era of general guidelines for the management of coronary artery disease patients, the tailored medicine approach is promising greater interest among physicians. Thus, understanding the different pathophysiological mechanisms that are at the basis of atherosclerosis is the key to precise medicine. In addition, not all acute plaque destabilizations exert symptoms. Indeed, most of the plaque rupture or erosion events occur without overt clinical signs, favoring plaque growth. The management of its residual risk remains a cornerstone in this field of research.

Non-invasive imaging techniques such as stress echocardiography and, more recently, myocardial strain evaluation allow for the early identification of patients with subclinical atherosclerosis and the stratification their residual risk. Coronary computed tomography angiography is also attracting a greater level of interest for plaque characterization and perivascular inflammation detection.

We are also in the age of novel LDL cholesterol treatments that dramatically reduce the rate of recurrent coronary events. However, the role of other lipoproteins in atherosclerosis, their management, and current predictors of recurrent coronary events remain to be investigated.  

Atherosclerosis may also present with micro-vessel dysfunction instead of significant epicardial vessel obstruction. The management of patients with myocardial infarction without obstructive coronary artery disease deserves tailored treatments.

Finally, even systemic diseases affecting other organs than the heart may impact the development and progression of both coronary plaque and endothelial dysfunction. These patients require specific treatment and an integrated approach.

This Special Issue, titled “Management of Atherosclerosis”, will focus on atherosclerosis progression, diagnostic techniques, and the current treatments that are available for this disease. To this end, state-of-the-art reviews as well as original research articles, focused on the pathophysiology and management of atherosclerosis, will be warmly welcomed.

Dr. Luca Di Vito
Guest Editor

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• plaque erosion
• plaque rupture
• myocardial strain
• coronary computed tomography angiography
• MINOCA
• recurrent coronary events
• PCSK9 inhibitors
• inclisiran
• microvascular dysfunction