Atherosclerotic disease is the underlying process behind the two leading causes of death worldwide: ischemic stroke and myocardial infarction. Its prevalence is remarkably high in Western populations, affecting up to 75% of men and 62% of women aged 65 and older. Despite advances in therapy, current screening and diagnostic strategies remain insufficient to identify high-risk individuals before an event occurs. However, over the past decade, increasing recognition of the concept of the "vulnerable plaque" has opened new and promising perspectives in cardiovascular medicine.

It is now widely accepted that rupture of atherosclerotic plaques—particularly in the coronary and carotid arteries—plays a fundamental role in triggering acute events such as myocardial infarction and ischemic stroke. Recent progress in imaging technologies has significantly enhanced our ability to investigate plaque morphology and composition, providing compelling evidence that specific imaging features are associated with a higher risk of rupture, thrombosis, or embolization.

At the same time, the advent of lipid-lowering and anti-inflammatory therapies has introduced a new dimension to the management of atherosclerosis, raising important questions about how best to integrate medical therapy and revascularization strategies. Although coronary and carotid atherosclerosis share a common pathological basis, they differ in several key aspects—biological behavior, clinical presentation, therapeutic response—which call for a more nuanced, disease-specific approach.

This conference aims to address these complexities through a multi-specialty dialogue that brings together leading experts from Europe, Asia and the United States. Cardiologists, neurologists, vascular surgeons, radiologists, and imaging scientists will engage in an open exchange to explore both the shared principles and the distinctive features of atherosclerosis in the heart and brain.

Our primary goal is to highlight recent innovations in the early imaging of atherosclerotic disease and to understand how such imaging can guide more tailored, effective prevention strategies—ultimately aiming to reduce the burden of myocardial infarction and ischemic stroke through individualized care.