James Muller explains roll of vulnerable plaque in preventive cardiology

For decades, cardiologists have known that most heart attacks are not triggered by large, stable blockages in the coronary arteries. Instead, the culprit is often smaller plaques that suddenly rupture with little warning. These vulnerable plaques are lipid-rich, inflamed deposits with thin fibrous caps that suddenly break open and trigger clot formation.

Detecting these dangerous plaques before they rupture is now becoming possible, James Muller, MD, a cardiologist at Brigham and Women’s Hospital and senior lecturer at Harvard Medical School, told Cardiovascular Business. Muller also co-founded the intravascular imaging companies Infraredx and SpectraWave.

“We introduced the concept in 1989 that there are hidden plaques in the artery wall that rupture and cause heart attack and sudden death,” Muller said. “After years of skepticism, the data have finally caught up. The controversy is over. Vulnerable plaques can be found.”