how the world dies today
TRANSCRIPT
How the World Dies Today?
YLLS: Years of Life LostW.H.O
W.H.O
Everybody has atherosclerosis, the question is who has vulnerable plaque
Sudden Cardiac DeathAcute MI
VulnerablePlaque(s)
Compensatory Enlargement of Human Atherosclerotic Coronary Arteries
N Engl J Med 1987 May 28;316(22):1371-5
<50% stenosis
Luminal area is not endangered until more than 40% of internal elastic lamina is destructed and occupied by plaque
Coronary artery disease is a disease of arterial wall disease not lumen.
Positive Remodeling<80%
stenosis
Plaque Eruption (Volcano!)
Different Types of Vulnerable Plaques Major Underlying Cause of
Acute Coronary Events
NormalRupture-prone
Fissured ErodedCritical Stenosis Hemorrhage
Naghavi et al, Cur Ath Rep 2001
How important is early detection of
vulnerable plaque?
In 70% of cases the first symptom of having a vulnerable plaque is sudden death outside of hospital.
1.5 million heart attacks, 6 million heart failures and 500,000 sudden deaths
can be prevented if
vulnerable plaque is detected and treated.
In search of “vulnerable patient”
1,400,000 Annual Heart Attacks
140,000,000 Americans >35y
Home-Based Screening
Non-invasive Imaging
Office-Based Screening
Invasive Dx with Rx 2-3
millions
40-50 millions
50-60 millions
Non-invasive
Home-Based Biomarkers (Glu, Chol, CRP, …)Self-Screening
Questionnaire
CT Calcium and Cholesterol Imaging
Noninvasive Angiography
Non-Invasive Molecular Imaging for Plaque and
Myocardium Characterization
Home and Office Based Endothelial F. Test, ECG…
Intravascular Ultrasound, Thermography, OCT, NIR
Spectroscopy…
Home-Based, Non-Invasive, Easy and Inexpensive
Non-Invasive Imaging
2001 2050
Genomic
Proteomic
2007 2015 2020 2040
VP Treatment
Home-based VP Screening Test
Heart Attack
Rate Falls Below 10,000
per year
Cloning Heart
VP Rx as OTC
and
Vaccine against heart attack
Eradication of Heart Attack
VP Detection
Mission:
