1. Biomarkers associated with coronary high-risk plaques
- Author
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Akihiro Nakajima, Peter Libby, Satoru Mitomo, Haruhito Yuki, Makoto Araki, Lena Marie Seegers, Iris McNulty, Hang Lee, Midori Ishibashi, Kazuna Kobayashi, Jouke Dijkstra, Toru Ouchi, Hirokazu Onishi, Hiroto Yabushita, Satoshi Matsuoka, Hiroyoshi Kawamoto, Yusuke Watanabe, Kentaro Tanaka, Shengpu Chou, Tomohiko Sato, Toru Naganuma, Masaaki Okutsu, Satoko Tahara, Naoyuki Kurita, Shotaro Nakamura, David J. Kuter, Sunao Nakamura, and Ik-Kyung Jang
- Subjects
Inflammation ,Optical coherence tomography ,Interleukin-6 ,Fibrinogen ,Hematology ,Biomarker ,Coronary Angiography ,Coronary Vessels ,Coronary artery disease ,Plaque, Atherosclerotic ,Bile Acids and Salts ,C-Reactive Protein ,Predictive Value of Tests ,Creatinine ,Humans ,Prothrombin ,Intravascular ultrasound ,Cardiology and Cardiovascular Medicine ,Homocysteine ,Ultrasonography, Interventional ,Tomography, Optical Coherence ,Biomarkers ,Vulnerable plaque - Abstract
Vascular inflammation, lipid metabolism, and thrombogenicity play a key role not only in atherogenesis but also in the development of acute coronary syndromes. Biomarkers associated with coronary high-risk plaques defined according to intravascular imaging have not been systematically studied. A total of 69 patients with coronary artery disease who underwent both optical coherence tomography and intravascular ultrasound imaging, and who provided blood specimens were included. Comprehensive biomarkers for inflammation, lipid, and coagulation were analyzed. Composite models sought biomarker patterns associated with thin-cap fibroatheroma (TCFA) and "high-risk plaques" (TCFA and large plaque burden). Two different composite models were developed for TCFA, based on the finding that high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor-1, fibrinogen, IL-6, homocysteine and amyloid A levels were elevated, and high-density lipoprotein cholesterol (HDL) and bile acid levels were decreased in these patients. Both composite models were highly accurate for detecting patients with TCFA (area under curve [AUC]: 0.883 in model-A and 0.875 in model-B, both p 0.001). In addition, creatinine, hsCRP, fibrinogen, tumor necrosis factor-α, IL-6, homocysteine, amyloid A, HDL, prothrombin, and bile acid were useful for detecting patients with "high-risk plaques". Two composite models were highly accurate for detection of patients with "high-risk plaques" (AUC: 0.925 in model-A and 0.947 in model-B, both p 0.001). Biomarkers useful for detection of patients with high-risk coronary plaques defined according to intravascular imaging have been identified. These biomarkers may be useful to risk stratify patients and to develop targeted therapy.Clinical Trial Registration https://www.umin.ac.jp/ctr/ , UMIN000041692. Biomarkers and high-risk plaques hsCRP, PAI-1, fibrinogen, IL-6, homocysteine, amyloid A, HDL, and bile acid were useful for detecting patients with TCFA. hsCRP, fibrinogen, IL-6, homocysteine, amyloid A, creatinine, TNFα, HDL, prothrombin, and bile acid were useful for detecting patients with "high-risk plaques" (plaque which has both TCFA and large plaque burden). White arrowhead denotes TCFA. Red and green dashed lines denote lumen area and external elastic membrane area, respectively.
- Published
- 2022