|What it originally meant|
|A plaque that is the culprit lesion for an acute coronary event|
|What it should mean|
|A plaque that is prone to rupture when all intrinsic and extrinsic effects are taken into account (regardless of structure)|
|How it is currently interpreted in the majority of literature|
|A plaque with specific morphological features—usually referring exclusively to thin cap fibroatheromas|
This table attempts to summarize the different connotations inherent in the term “vulnerable plaque.” It can be appreciated that a teleological approach has shifted toward a utilitarian one, allowing for easier classification of plaques as “vulnerable” or not, yet depriving this characterization of prognostic implications.