Plaque Biology: Interesting Science or Pharmacological Treasure Trove?

Our understanding of the events that occur within atherosclerotic plaques has improved dramatically over the last 2 decades, particularly with regard to the role of plaque destabilisation and the onset of clinical ischaemic syndromes. Many potential targets have been identified for therapeutic intervention aimed at disease prevention, plaque stabilisation and regression. Furthermore, many potential biomarkers of vascular disease have generated interest in terms of monitoring disease activity and the effect of therapeutic agents. However, despite much scientific promise with in vitro cell and animal models, there has been much less success in modulation of these processes in clinical practice. This review will highlight the local and systemic factors associated with disease progression and acute plaque destabilisation, the current role of therapeutic agents and the potential for targeted plaque modification.