The causes of heart attacks are shifting in this era of better control of cholesterol, blood pressure, and smoking and fewer instances of fatty plaque rupturing and causing blood clots. But a different cause of clots seems to be on the rise: superficial erosion. The underlying cause of clots is a hot research area because we can learn how to personalize treatment of acute heart attacks instead of using a one-size-fits-all approach. In this interview, Deepak Bhatt, MD, FACC; Peter Libby, MD, FACC; and Matt Cavender, MD, MPH, FACC, share a vascular biology update on vulnerable plaques. For 20+ insider interviews like these every month with CME/MOC credit, subscribe to ACCEL at www.ACC.org/ACCEL.