To the Editor We read the article by Vergallo et al1 with great interest. We commend the authors for having advanced our understanding of the association of coronary atherosclerotic phenotype with risk of acute cardiovascular events. The finding that lipid-rich plaques and thin-cap fibroatheromas were significantly less common in patients who had never been unstable (ie, patients with long-standing stable angina pectoris [ls-SAP]) than in patients with multiple recurrent events (ie, patients with recurrent acute coronary syndromes [rACS])1 highlights the need to (1) identify patients with high-risk atherosclerosis and (2) more vigorously address plaque phenotype in clinical care.
Lechner K, Halle M. Are Atherogenic Lipoprotein Phenotype and Inflammation Indicative of Plaque Phenotype and Clinical Stability in Coronary Artery Disease? JAMA Cardiol. Published online July 17, 20194(9):950–951. doi:10.1001/jamacardio.2019.2261
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