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Adverse plaque characteristics and hemodynamic interplay. (A) Intermediate lesion with thick fibrous cap and lipid-rich core experience axial plaque stress and increased wall shear stress (WSS) associated with hemodynamic impairment; (B) regression of fibrous cap to thin fibrous cap and increase lipid content (49); (C) disruption of the thin fibrous cap from persistent external hemodynamic stress resulting in plaque result and acute coronary syndrome (ACS) (50).
