A recent article published in Current Opinion in Pharmacology reported that recent findings have revealed that the development of the atherosclerotic plaque, the basic entity in carotid and coronary artery disease, may share similar characteristics and mechanisms, irrespective of its site. It was stated that despite the biology of atherosclerotic process being similar, there lies differences in plaque morphology and characteristics. Additionally, plaque erosion, calcified nodules, fibrous cap thickness and macrophage accumulation may be different in the setting of coronary and carotid artery disease. Furthermore, perivascular adipose tissue surrounding coronary arteries (but not carotids) may also affect plaque biology.