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Risk factors for development of atherosclerosis have been described and it is a challenge to develop risk scores that can be applied for individual patients. Specific predictors for progression of atherosclerosis and secondary manifestations of the disease are lacking. The search for new serological and genetic markers predictive for cardiovascular events is an emerging research field. Local plaque instability can give rise to thromboembolic cardiovascular events, which suggests that certain information might be enclosed in local atherosclerotic tissue. Because of the systemic character of atherosclerosis, it can be hypothesized that local plaque characteristics encompass information of other atherosclerotic lesions throughout the vascular tree. Biobank studies with a longitudinal design have been initiated to investigate the link between characteristics of local atherosclerotic tissue and outcome during follow up. 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