At this point in time, the identification of the “I” score may not be very precise. The introduction

of the “I” score might prove more useful when a precise method for the identification of instability is identified. However, clinical acute coronary events can always be deemed the highest “I” score. This equation can be used in prospective studies on the association between traditional and novel risk factors and atherosclerosis velocity. A summary Inhibitors,research,lifescience,medical of the description and application of atherosclerosis velocity can be observed in figure 2. Importance of Atherosclerosis Velocity We believe that in several previous investigations, atherosclerosis velocity has not been sufficiently studied. In other words, as much as we currently know various parameters believed to be the causative or consequence factors of atherosclerosis, we really do not have a good understanding of the effects of these factors on atherosclerosis velocity. Saremi et al.17 reported that Pioglitazone, a drug of the HKI-272 mouse Thiazolidinedione class with hypoglycemic action to Inhibitors,research,lifescience,medical treat diabetes, slowed the progression of carotid intima media thickness (IMT) during an average follow-up of 2.3 years compared to placebo. Inhibitors,research,lifescience,medical Imagine if another study examines compound X in a matched group of patients and reaches the same curve of IMT decrease but in one year; it would mean that compound X could decrease atherosclerosis velocity almost by 50%. Another example

Inhibitors,research,lifescience,medical in this regard is the study of Yamazaki et al.18 They showed that in patients under statin therapy at a 12-month measurement point, mean-IMT change was correlated with LDL-C and LDL-C/ HDL-C. Sun et al.19

recently performed an interesting study which almost combined all three parameters of time/ duration, plaque volume, and plaque vulnerability/instability characteristics. The authors characterized the impact of atherosclerosis on the short-term (6 months) natural history of the lipid-rich Inhibitors,research,lifescience,medical necrotic core (LRNC) in carotid artery plaques using MRI and concluded that LRNC was essentially affected by the characteristics of plaque stability, which seemed to be even more important than clinical features. Several previous articles have concluded that atherosclerosis is a chronic disease.4,5 However, we think that it is time we considered the term “acute atherosclerosis”. selleck inhibitor Acute atherosclerosis represents a rupture-induced occlusion and is a disorder that may develop even a very short time after plaque formation. Atherosclerosis velocity has dependency on plaque stabilization and acute rupture. Therefore, if we assume that the endpoint of atherosclerosis is acute coronary occlusion and/or gradual arterial narrowing-induced ischemia, we should then turn our attention to the risk factors that contribute to a rise in atherosclerosis velocity. Inflammation is known to be a crucial component of atherosclerosis10,20,21 and plays an important role in plaque instability.