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Updated: Jul 1, 2026
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Optical coherence tomography-derived macrophage arc as a novel biomarker for predicting adverse cardiovascular events
1Department of Cardiology, Xinqiao Hospital, Army Medical University, No.183 Xinqiao Avenue, Shapingba District, Chongqing, 400037, China.
Aims:
Macrophages play a crucial role in coronary artery plaque development and can be quantified as circumferential arc features via optical coherence tomography (OCT). However, the prognostic implications of macrophage arc characteristics remain underexplored.
Methods And Results:
In this multicentre, retrospective study, consecutive patients with coronary artery disease (CAD) undergoing OCT between January 2017 and April 2023 were enrolled. The macrophage arc was evaluated using maximum arc, mean arc, and mean arc score (MAS) in the target vessel. Among 1025 patients (1173 vessels), 61 (5.9%) experienced major adverse cardiovascular events (MACEs). Receiver operating characteristic analysis identified optimal predictive thresholds: maximum arc ≥ 157.5°, mean arc ≥ 97.88°, and MAS ≥ 2.27 (all P < 0.001). Elevated mean arc [hazard ratio (HR) = 7.628, P < 0.0001], maximum arc (HR = 6.902, P < 0.0001), and MAS (HR = 6.704, P < 0.0001) were independently associated with MACEs. When combined with thin-cap fibroatheroma (TCFA) status, these parameters demonstrated enhanced predictive power: mean arc ≥ 97.88° + TCFA (HR = 8.779, P < 0.0001), maximum arc ≥ 157.5° + TCFA (HR = 8.149, P < 0.0001), and MAS ≥ 2.27 + TCFA (HR = 7.509, P < 0.0001). Notably, among TCFA-negative patients, a mean arc ≥ 97.88° showed markedly improved predictive capacity for MACEs (HR = 6.685, P < 0.001), as did maximum arc ≥ 157.5° (HR = 4.490, P < 0.001) and MAS ≥ 2.27 (HR = 5.126, P < 0.001).
Conclusion:
Macrophage arc parameters are strongly associated with long-term cardiovascular risk, serving as novel OCT-derived biomarkers for patients with CAD.
Insights
Macrophage arc characteristics measured by optical coherence tomography (OCT) predict cardiovascular events in coronary artery disease (CAD) patients. These OCT-derived macrophage features offer novel prognostic insights for long-term cardiovascular risk assessment.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Biomarkers
Background:
- Macrophages are key in coronary artery plaque development.
- Optical coherence tomography (OCT) quantifies macrophage presence as circumferential arcs.
- The prognostic value of these macrophage arc characteristics is not well understood.
Purpose of the Study:
- To investigate the prognostic implications of macrophage arc characteristics derived from OCT in patients with coronary artery disease (CAD).
- To determine if macrophage arc parameters can predict major adverse cardiovascular events (MACEs).
Main Methods:
- A multicentre, retrospective study of 1025 patients with CAD undergoing OCT.
- Evaluation of macrophage arc using maximum arc, mean arc, and mean arc score (MAS).
- Analysis of association between macrophage arc parameters and MACEs, including in combination with thin-cap fibroatheroma (TCFA) status.
Main Results:
- Elevated mean arc, maximum arc, and MAS were independently associated with MACEs.
- Combining macrophage arc parameters with TCFA status enhanced MACE prediction.
- In TCFA-negative patients, specific macrophage arc thresholds significantly improved MACE prediction.
Conclusions:
- Macrophage arc parameters derived from OCT are strong predictors of long-term cardiovascular risk.
- These OCT-derived macrophage features represent novel biomarkers for prognostication in CAD patients.
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