Finding and understanding the vulnerable plaque and patient to prevent cardiovascular events

Background Coronary imaging has opened a new field were the cause of myocardial infarction MI and sudden death can be revealed before the events happen. Our PROSPECT II defined the vulnerable plaque that cause MI as having high plaque burden and being lipid rich.

These findings give us the opportunity to develop methods to find the vulnerable plaque and patient before events and give preemptive treatment.Objectives To improve and validate coronary imaging methods to detect vulnerable plaques.

To develop methods to treat vulnerable plaques To evaluate panomics to understand mechanisms of coronary disease and to find vulnerable patients. To use machine learning to identify the vulnerable patient.

To improve coronary flow to prevent cardiovascular events.Work plan Project I: The substudies of PROSPECT II has started and will continue for several years.The long-term follow-up will be initiated 2023.

Validation of the new NIRS-OCT technology.Project II: Large vulnerable plaque treatment studies.Project III: Proteomics, metabolomics, miRNA and full transcriptomics for vulnerable plaque.Project IV: AI will be used both on clinical data and imaging.Project V: Here we have leads on proteins and miRNA that are associated with CFR.

Mechanistic studies are ongoing.

Significance The current application aims at identifying the vulnerable patient and plaque before the MI happens and to treat preemptively. This could have significant importance, change clinical practice and guidelines.