In this study, we phenotyped lesions with silent plaque ruptures (PR) in non infarct related vessels of 336 AMI patients and found:

• larger plaque volume, positive remodeling, and thinner fibrous cap associated with rupture.
• Biomarkers (eg LDL-C, Lp(a), IFNγ, interleukin-6; MMP-12; TNFα, hsCRP) were not correlated with multivessel plaque instability.
• 50% of plaques healed at 1 YR imaging with OCT.

All patients received high intensity statin therapy (at least), and the majority of healed plaques transformed into a fibrous morphology.
Although not powered for events, no excess in CV outcomes was noted in the PR group.

Great Editorial by Aloke Finn, Renu Virmani, CV Path Institute, Washington: silent culprit: why ‘hidden’ plaque ruptures matter | European Heart Journal | Oxford Academic

Congratulations to the first author Ryota Kakizaki who spent a successful 3 year fellowship at the Department of Cardiology at Insel Gruppe and we are proud on his persistence on this project published in the European Heart Journal.