Plaque Vulnerability and Cardiovascular Risk Factor Burden in Acute Coronary Syndrome: An Optical Coherence...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Pathology

Background:

• Cardiovascular risk factors are linked to poor outcomes in acute coronary syndrome (ACS).
• While individual risk factors are associated with specific plaque types, the impact of cumulative risk factors on plaque vulnerability is unclear.

Purpose of the Study:

• To investigate the association between the number of cardiovascular risk factors and plaque vulnerability.
• Plaque vulnerability was assessed using optical coherence tomography (OCT).

Main Methods:

• Patients with ACS were grouped by the number of traditional risk factors (diabetes, hypertension, hyperlipidemia, smoking).
• Vulnerable plaque features were analyzed in both culprit and non-culprit lesions using OCT.
• Groups included 0-1 risk factors versus 2 or more risk factors.

Main Results:

• In culprit lesions, increased risk factors correlated with higher prevalence of lipid-rich plaques, thin-cap fibroatheromas, macrophages, microvessels, and cholesterol crystals.
• Having 2 or more risk factors was linked to all vulnerable features except lipid-rich plaques.
• Plaque rupture increased with more risk factors, while plaque erosion decreased.
• Non-culprit lesions showed associations between risk factors and macrophages, cholesterol crystals, and cumulative vulnerable features.

Conclusions:

• An increasing number of cardiovascular risk factors is strongly associated with greater plaque vulnerability in ACS patients, particularly in culprit lesions.
• These findings help explain the link between traditional risk factors and adverse clinical events.