Atherosclerosis

A 52-year-old woman with a history of type 2 diabetes and chronic kidney disease (eGFR 35 mL/min/1.73 m²) is being evaluated for asymptomatic coronary artery disease (CAD). She has no chest pain but has multiple risk factors. Which investigation is most appropriate to assess the extent and severity of atherosclerotic plaque burden and guide further management without exposing her to iodinated contrast?

Which histopathological feature best distinguishes a stable atherosclerotic plaque from a vulnerable (rupture-prone) plaque?

A 58-year-old man with a 20-year history of smoking and hypertension undergoes coronary angiography after an acute anterior wall MI. Histology of the culprit lesion shows extensive calcification, dense collagen, and minimal lipid content. In contrast, an incidental lesion in the right coronary artery shows a large lipid pool with sparse smooth muscle cells and heavy macrophage infiltration. Which feature best distinguishes the acute thrombotic lesion from the chronic stable lesion?

In the pathogenesis of atherosclerosis, which of the following is the earliest morphologic change visible in the arterial wall?

A 58-year-old man with a 10-year history of type 2 diabetes and hypertension presents with stable angina. His LDL cholesterol is 145 mg/dL despite lifestyle modifications. Coronary angiography reveals 60% stenosis in the left anterior descending artery. Which drug is the first-line agent to reduce his cardiovascular risk and slow atherosclerotic progression?