Rationale and approach to evaluation of the impact of medical therapies on progression of atherosclerosis with arterial wall imaging.

Background: Despite the benefit of medical therapies, there remains a substantial residual risk of cardiovascular events. Atherosclerosis imaging has been used to assess new therapies.

Scope: A selective review of current imaging techniques used to evaluate novel anti-atherosclerotic therapies.

Findings: Noninvasive and invasive arterial wall imaging permits characterization of the quantity and composition of atherosclerotic plaque. Serial imaging enables assessment of the impact of therapies on the natural history of disease progression.

Conclusion: Both noninvasive and invasive imaging modalities can be used in development programs to provide an early assessment of the impact of novel anti-atherosclerotic agents.