Skip to main content

Table 1 Human coronary morphological plaque vulnerability index (MPVI) definition and AHA classifications

From: Human coronary plaque wall thickness correlated positively with flow shear stress and negatively with plaque wall stress: an IVUS-based fluid-structure interaction multi-patient study

MPVI Plaque Description AHA classification
V = 0 Very stable Normal or slight intimal thickening Type I, some atherogenic lipoprotein and intimal thickening
V = 1 Stable Moderate intimal thickening, no extracellular lipid, calcification or significant inflammation Type II (fatty streak), III (preatheroma)
V = 2 Slightly unstable Small lipid core (<30% of plaque size); calcification may be present; thick fibrous cap (> 150 μm); little or no inflammation at plaque shoulders Type IV, Vb, and Vc with less than 30% NC by area; or VII/VIII
V = 3 Moderately unstable Moderate lipid core (30 – 40% of plaque size) and fibrous cap (65 – 150 μm); moderate intraplaque hemorrhage; moderate inflammation. Type Va, IV/V with 30-40% NC by area
V = 4 Highly unstable Large lipid core(>40%); thin fibrous cap (< 65 μm); large intraplaque hemorrhage; extensive inflammation; evidence of previous plaque rupture Type VI; IV/V with > 40% NC by area
  1. Cap thickness threshold values were modified from previously published values to adjust to the differences between coronary and carotid plaques based on available literature.