Higher Triglyceride Levels Are Associated with the Higher Prevalence of Layered Plaques in Non-culprit Coronary Plaques

Overview

Journal J Thromb Thrombolysis

Specialty Cardiology & Vascular Diseases

Date 2023 Sep 13

PMID 37702855

Authors

Kiyoshi Asakura

Yoshiyasu Minami

Takako Nagata

Masahiro Katamine

Yusuke Muramatsu

Daisuke Kinoshita

Junya Ako

Affiliations

Soon will be listed here.

Abstract

High triglyceride (TG) levels have been recognized as a risk factor for cardiovascular events in patients with coronary artery disease (CAD). This study aimed to clarify the association between TG levels and characteristics of non-culprit coronary plaques in patients with CAD. A total of 531 consecutive patients with stable CAD who underwent percutaneous coronary intervention for culprit lesions and optical coherence tomography (OCT) assessment of non-culprit plaques in the culprit vessel were included in this study. The morphology of the non-culprit plaques assessed by OCT imaging were compared between the higher TG (TG ≥ 150 mg/dL, n = 197) and lower TG (TG < 150 mg/dL, n = 334) groups. The prevalence of layered plaques (40.1 vs. 27.5%, p = 0.004) was significantly higher in the higher TG group than in the lower TG group, although the prevalence of other plaque components was comparable between the two groups. High TG levels were an independent factor for the presence of layered plaques (odds ratio 1.761, 95% confidence interval 1.213-2.558, p = 0.003) whereas high low-density lipoprotein cholesterol levels (≥ 140 mg/dL) and low eicosapentaenoic acid/arachidonic acid ratios (< 0.4) were independently associated with a higher prevalence of thin-cap fibroatheroma and macrophages. Higher TG levels were associated with a higher prevalence of layered plaques in non-culprit plaques among patients with stable CAD. These results may partly explain the effect of TG on the progression of coronary plaques and the increased incidence of recurrent events in patients with CAD.

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References

Faergeman O, Holme I, Fayyad R, Bhatia S, Grundy S, Kastelein J . Plasma triglycerides and cardiovascular events in the Treating to New Targets and Incremental Decrease in End-Points through Aggressive Lipid Lowering trials of statins in patients with coronary artery disease. Am J Cardiol. 2009; 104(4):459-63. DOI: 10.1016/j.amjcard.2009.04.008. View

Schwartz G, Abt M, Bao W, DeMicco D, Kallend D, Miller M . Fasting triglycerides predict recurrent ischemic events in patients with acute coronary syndrome treated with statins. J Am Coll Cardiol. 2015; 65(21):2267-75. DOI: 10.1016/j.jacc.2015.03.544. View

Patel S, Puranik R, Nakhla S, Lundman P, Stocker R, Wang X . Acute hypertriglyceridaemia in humans increases the triglyceride content and decreases the anti-inflammatory capacity of high density lipoproteins. Atherosclerosis. 2008; 204(2):424-8. DOI: 10.1016/j.atherosclerosis.2008.07.047. View

Wang L, Gill R, Pedersen T, Higgins L, Newman J, Rutledge J . Triglyceride-rich lipoprotein lipolysis releases neutral and oxidized FFAs that induce endothelial cell inflammation. J Lipid Res. 2008; 50(2):204-13. PMC: 2636918. DOI: 10.1194/jlr.M700505-JLR200. View

Asakura K, Minami Y, Kinoshita D, Katamine M, Kato A, Katsura A . Impact of triglyceride levels on plaque characteristics in patients with coronary artery disease. Int J Cardiol. 2021; 348:134-139. DOI: 10.1016/j.ijcard.2021.12.008. View

Stone G, Maehara A, Lansky A, De Bruyne B, Cristea E, Mintz G . A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011; 364(3):226-35. DOI: 10.1056/NEJMoa1002358. View

Erlinge D, Maehara A, Ben-Yehuda O, Botker H, Maeng M, Kjoller-Hansen L . Identification of vulnerable plaques and patients by intracoronary near-infrared spectroscopy and ultrasound (PROSPECT II): a prospective natural history study. Lancet. 2021; 397(10278):985-995. DOI: 10.1016/S0140-6736(21)00249-X. View

Xing L, Higuma T, Wang Z, Aguirre A, Mizuno K, Takano M . Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography: A 4-Year Follow-Up Study. J Am Coll Cardiol. 2017; 69(20):2502-2513. DOI: 10.1016/j.jacc.2017.03.556. View

Prati F, Romagnoli E, Gatto L, La Manna A, Burzotta F, Ozaki Y . Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study. Eur Heart J. 2019; 41(3):383-391. DOI: 10.1093/eurheartj/ehz520. View

10.

Fracassi F, Crea F, Sugiyama T, Yamamoto E, Uemura S, Vergallo R . Healed Culprit Plaques in Patients With Acute Coronary Syndromes. J Am Coll Cardiol. 2019; 73(18):2253-2263. DOI: 10.1016/j.jacc.2018.10.093. View

11.

Araki M, Yonetsu T, Kurihara O, Nakajima A, Lee H, Soeda T . Predictors of Rapid Plaque Progression: An Optical Coherence Tomography Study. JACC Cardiovasc Imaging. 2020; 14(8):1628-1638. DOI: 10.1016/j.jcmg.2020.08.014. View

12.

Usui E, Mintz G, Lee T, Matsumura M, Zhang Y, Hada M . Prognostic impact of healed coronary plaque in non-culprit lesions assessed by optical coherence tomography. Atherosclerosis. 2020; 309:1-7. DOI: 10.1016/j.atherosclerosis.2020.07.005. View

13.

Araki M, Park S, Dauerman H, Uemura S, Kim J, Di Mario C . Optical coherence tomography in coronary atherosclerosis assessment and intervention. Nat Rev Cardiol. 2022; 19(10):684-703. PMC: 9982688. DOI: 10.1038/s41569-022-00687-9. View

14.

Yamamoto M, Yamashita K, Matsumura M, Fujino A, Ishida M, Ebara S . Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina Pectoris. Circ Cardiovasc Imaging. 2017; 10(9). DOI: 10.1161/CIRCIMAGING.117.006347. View

15.

Kitabata H, Tanaka A, Kubo T, Takarada S, Kashiwagi M, Tsujioka H . Relation of microchannel structure identified by optical coherence tomography to plaque vulnerability in patients with coronary artery disease. Am J Cardiol. 2010; 105(12):1673-8. DOI: 10.1016/j.amjcard.2010.01.346. View

16.

Liu L, Gardecki J, Nadkarni S, Toussaint J, Yagi Y, Bouma B . Imaging the subcellular structure of human coronary atherosclerosis using micro-optical coherence tomography. Nat Med. 2011; 17(8):1010-4. PMC: 3151347. DOI: 10.1038/nm.2409. View

17.

Domei T, Yokoi H, Kuramitsu S, Soga Y, Arita T, Ando K . Ratio of serum n-3 to n-6 polyunsaturated fatty acids and the incidence of major adverse cardiac events in patients undergoing percutaneous coronary intervention. Circ J. 2011; 76(2):423-9. DOI: 10.1253/circj.cj-11-0941. View

18.

Matsumoto I, Moriya S, Kurozumi M, Namba T, Takagi Y . Simultaneous evaluation of fatty acid and triglycerides after percutaneous coronary intervention. J Cardiol. 2022; 80(2):149-154. DOI: 10.1016/j.jjcc.2022.02.011. View

19.

Bhatt D, Steg P, Miller M, Brinton E, Jacobson T, Ketchum S . Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2018; 380(1):11-22. DOI: 10.1056/NEJMoa1812792. View

20.

Vergallo R, Crea F . Atherosclerotic Plaque Healing. N Engl J Med. 2020; 383(9):846-857. DOI: 10.1056/NEJMra2000317. View