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The Vulnerable Plaque Theory: Can We Predict When a Plaque Will Blow?

1,998 views · Published 4 October 2017 · 10:08 · Indexed 4 October 2026

Channel: Dr. Ford Brewer MD MPH · 2017 · Science & Technology

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Dr. Brewer started as an Emergency Doctor.  After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine.  While there, he went on the run the post-graduate training program (residency) in Preventive Medicine.  From there, he made a career of practicing and managing preventive medicine and primary care clinics.  His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics.  He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.

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ABOUT THIS VIDEO:
ford brewer md mph   PrevMedHeartRisk.com
Despite knowing when people have atherosclerosis, we cannot predict when an individual is at risk for immediate heart attack or stroke event. 
Logically, that's surprising when you consider that vascular imaging can clearly show us when plaques are "hot" (they have a liquid necrotic core), and the plaque cap is getting thin. 
There are companies that have been started to do just this. InfraReDx is one such company. It used an infrared technology to characterize these vulnerable. Dr James Mullner was the CEO. But he is no more. It doesn't look like things are going well with InfraReDx. Why? 
The other side of the debate seems to be winning. Dr. Steven Nissen, chair of cardiology at Cleveland Clinic has been a major proponent of the side that says "it's a systemic issue. You can't target just one vulnerable plaque. That's a myth." 
I agree with them.

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