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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Linking Systemic Inflammation to Coronary Lesion Complexity: A Combined FFR and OCT Study

Nicoleta-Monica Popa-Fotea1,2, Miruna-Mihaela Micheu2, Lucian Calmac1,2

  • 1Department of Cardiology, University of Medicine and Pharmacy Carol Davila, 8, Eroii Sanitari, 050474 Bucharest, Romania.

International Journal of Molecular Sciences
|November 13, 2025
PubMed

Insights

Higher levels of inflammatory biomarkers interleukin-1 receptor antagonist (IL-1ra), resistin, and C-reactive protein (CRP) are linked to more complex coronary artery disease in acute coronary syndrome (ACS) patients. This suggests inflammatory markers can help assess ACS risk and vulnerability.

Area of Science:

  • Cardiovascular Medicine
  • Biomarkers
  • Atherosclerosis Research

Background:

  • Residual inflammation post-acute coronary syndrome (ACS) drives atherosclerosis progression and plaque instability.
  • Key inflammatory biomarkers like interleukin-1 receptor antagonist (IL-1ra), resistin, and C-reactive protein (CRP) may indicate coronary lesion complexity and vulnerability.

Purpose of the Study:

  • To assess the association between IL-1ra, resistin, and CRP levels with coronary disease extent, functional significance of non-culprit lesions (FFR), and plaque vulnerability (OCT-defined TCFA) in ACS patients.

Main Methods:

  • Prospective study of 93 ACS patients undergoing invasive coronary assessment.
  • Measured inflammatory biomarkers at admission and 6 months.
  • Stratified patients into tertiles by biomarker levels.
  • Assessed coronary disease extent (SYNTAX score), lesion significance (FFR), and plaque morphology (OCT-defined TCFA).
  • Utilized multivariate logistic regression analysis.

Main Results:

  • Higher tertiles of IL-1ra, resistin, and CRP correlated with increased SYNTAX scores, reduced FFR (<0.80), and higher prevalence of thin-cap fibroatheroma (TCFA).
  • Specifically, 68% in the highest tertile had FFR < 0.80, and 62% had TCFA compared to 20% in lower tertiles.
  • IL-1ra, resistin, and CRP independently predicted high-risk coronary profiles in multivariate models.

Conclusions:

  • IL-1ra, resistin, and CRP are independently associated with coronary lesion complexity, functional significance, and vulnerability in ACS patients.
  • Inflammatory biomarker profiling offers a complementary approach to anatomical and physiological assessments for ACS risk stratification.

Keywords:
C-reactive proteinfractional flow reserveinterleukin-1 receptor antagonistoptical coherence tomographyresistin

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