Vulnerable Plaque Detection & Treatment Program (VPP)
Personnel

Jerome Ackerman, PhD

Thomas Brady, MD
Professor Radiology

Brett Bouma, PhD
Asst. Professor Physics

Ray Chan, PhD
Instructor Computer Science

 Christian Farrar, PhD
MR Fellow Physical Chemistry

Maros Ferencik, MD
CT Fellow Internal Medicine

Karen Furie, MD
Instructor Neurology

Michael Hamblin, PhD
Asst. Professor Chemistry

 Udo Hoffmann, MD
Instructor Radiology

 IK Jang, MD
Assoc. Professor Cardiology
James Muller, MD
Co-Director

Lynn Osborn, MBA
Executive Director Management

Vivek Reddy, MD
Asst. Professor Cardiology

 Ahmed Tawakol, MD
Instructor Cardiology

Gary Tearney, MD, PhD
Asst. Professor Pathology
Sophia Cheng
Administrative Assistant

Thomas Brady, MD and James Muller, MD, Co-Directors

The CIMIT Vulnerable Plaque Program (VPP) utilizes multiple novel technologies in the development of methods to detect and treat vulnerable plaques in the coronary and carotid arteries. Application of these techniques will prevent many cases of heart attack and stroke, thereby leading to massive decreases in cardiovascular morbidity and mortality.

The Problem
Cardiovascular disease continues to be the leading cause of death and disability in the developed world. The causes of most heart attacks and strokes are vulnerable coronary and carotid plaques that are not detectable by current diagnostic methods. It is generally thought that the most common histologic type of vulnerable plaque is a lesion with a thin fibrous cap, a large lipid pool, and abundant macrophages. If such plaques could be detected and treated prior to disruption, a major advance in healthcare would be achieved.

The Solution
The causation of most acute cardiovascular events is relatively well understood, setting the stage for their prevention. The early detection of the plaques at high risk of causing an event is a critical step in prevention. Rapid developments in technology have created possibilities for detection and local treatment that did not exist ten years ago. The CIMIT Vulnerable Plaque Program is applying these new technologies to clinical challenges.

The most highly developed of the CIMIT VPP projects is the technique of Optical Coherence Tomography (OCT). CIMIT provided early funding to Dr. Brett Bouma and Dr. Gary Tearney which made possible the creation of a system to perform OCT in patients with coronary artery disease. Drs. IK Jang, Bouma, Tearney and others obtained the first OCT images of plaques causing disease in the coronary arteries of living patients. It has been demonstrated that OCT can detect lipid pools, thin caps, and macrophages -- the histologic features considered to be the most important components of vulnerable plaque. OCT has also been applied to the study of carotid plaques.

In addition to OCT, the CIMIT program is developing other invasive and non-invasive techniques to identify and treat vulnerable plaque.

CIMIT Value
CIMIT provides the multi-disciplinary and multi-institutional collaboration that is needed for the development of multiple devices and therapies to identify and treat vulnerable plaque. As a funding source, CIMIT has provided opportunities for novel approaches to collect the preliminary data that is then used to obtain additional funding from traditional sources. There are currently twenty-three CIMIT grants related to vulnerable plaque, for a total funding of $3.2 million. Seven additional grants have been submitted for a total requested funding of approximately $5 million.

The CIMIT Vulnerable Plaque Program consists of three components:

  1. Over 20 research projects ranging from New Concept grants to sponsored research agreements.
  2. A weekly lecture series for which videotapes and written summaries are provided.
  3. International Symposia -- The first international VPP symposium was held in September 2001. The second symposium, cosponsored by the National Heart Lung and Blood Institute and with the participation of the FDA, will be held in January 2004.

Vision for 2008
To contribute to a system for prevention of heart attack and stroke that will be available throughout the world.

Impact on Patient Care
The CIMIT VPP, together with other scientists from throughout the world, intends to contribute to a plan of care that will prevent most heart attacks and strokes. The system would work in the following manner:

  1. Individuals at risk for a cardiovascular event will be identified by the traditional risk factors.
  2. Risk predictions will be further refined when patients considered to be at increased risk undergo blood tests, which are likely to include plasma markers of inflammation and genetic risk.
  3. Patients found to be at intermediate or higher risk by risk factors and blood tests will undergo non-invasive testing for signs of vulnerable plaque.
  4. Individuals with a positive non-invasive test will have their risk further clarified with an intravascular method.
  5. Both systemic and local treatment will be given for vulnerable plaques to prevent heart attacks and strokes.
Non-Vulnerable Plaque & Vulnerable Plaque


 Above: Non-vulnerable plaque with fibrous tissue that partially blocks blood flow but not likely to cause a clot or cardiac event.


Above: Vulnerable plaque
with a lipid-rich core
and a thin fibrous cap.

Lecture Schedule

Publications

The goal of the CIMIT Vulnerable Plaque Program is to reduce cardiovascular morbidity and mortality by bringing together scientists, engineers and clinicians to accelerate the development and applications of methods to detect and treat vulnerable plaque.


We are grateful for major funding for the CIMIT Vulnerable Plaque Program provided by the following sponsors:

Cordis Website

We are also grateful for additional funding provided by these contributors:



Guidant Website

Terumo Website