Biomarkers associated with coronary high-risk plaques.

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Atherosclerosis Research

Background:

• Vascular inflammation, lipid metabolism, and thrombogenicity are crucial in atherogenesis and acute coronary syndromes.
• Identifying biomarkers for high-risk coronary plaques, particularly those defined by intravascular imaging, remains an unmet clinical need.

Purpose of the Study:

• To systematically investigate comprehensive biomarkers associated with coronary high-risk plaques, including thin-cap fibroatheroma (TCFA).
• To develop and validate composite biomarker models for accurate detection of TCFA and high-risk plaques.

Main Methods:

• Analysis of comprehensive inflammation, lipid, and coagulation biomarkers in 69 patients with coronary artery disease.
• Utilized optical coherence tomography (OCT) and intravascular ultrasound (IVUS) imaging to define plaque characteristics.
• Developed and validated two composite biomarker models for TCFA and high-risk plaques using logistic regression and AUC analysis.

Main Results:

• Elevated levels of high-sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor-1 (PAI-1), fibrinogen, IL-6, homocysteine, and amyloid A, along with decreased high-density lipoprotein cholesterol (HDL) and bile acid, were associated with TCFA.
• Composite models demonstrated high accuracy in detecting TCFA (AUC: 0.883-0.875) and high-risk plaques (AUC: 0.925-0.947).
• Creatinine, tumor necrosis factor-α (TNFα), and prothrombin were also identified as useful biomarkers for high-risk plaques.

Conclusions:

• Specific combinations of biomarkers have been identified as highly effective in detecting patients with TCFA and high-risk coronary plaques.
• These identified biomarkers hold potential for improving risk stratification strategies in patients with coronary artery disease.
• The findings may facilitate the development of targeted therapeutic interventions for individuals with vulnerable coronary plaques.