Coronary disease & ACSMechanistic study
Association Between Cardiovascular Risk Factors and Pan-Coronary Plaque Burden, Phenotype, and Vulnerability
- 3-vessel optical coherence tomography imaging study
Authors' conclusion
As the number of cardiovascular RFs increased, the number of plaques, plaques with a high-risk phenotype, and vulnerable features also increased. Only increasing modifiable RF burden was associated with greater pan-coronary vulnerability, including more TCFAs and LRPs.
Study context
- Population
- Patients undergoing 3-vessel optical coherence tomography imagingpatients (36.6% acute coronary syndromes (ACS)), 534 plaques analyzed
- Participants
- 131 patients
- Comparison
- Association between risk factors (RFs) (modifiable and non-modifiable) and pan-coronary plaque burden, plaque phenotype, and features of vulnerability
Main finding
As reported in the abstract
Number of plaques by number of RFs
Number of plaques increased as the number of RFs increased
P trend = 0.001
Further findings
| Outcome | IRR (95% CI) | P value | |
|---|---|---|---|
| Pan-coronary vulnerability per modifiable RF burden (multivariable) — modifiable RF burden · pan-coronary vulnerability · multivariable analyses | 1.36 (1.18–1.57) | P < 0.001 | |
| Pan-coronary vulnerability per modifiable RF burden (multivariable) — modifiable RF burden · TCFAs · multivariable analyses | 1.48 (1.20–1.83) | P < 0.001 | |
| Pan-coronary vulnerability per modifiable RF burden (multivariable) — modifiable RF burden · LRPs · multivariable analyses | 1.35 (1.15–1.59) | P < 0.001 | |
| Pan-coronary vulnerability per modifiable RF burden (multivariable) — modifiable RF burden · cholesterol crystals · multivariable analyses | 1.50 (1.21–1.87) | P < 0.001 | |
| 0.512Incidence rate ratio (log scale) |
- Pan-coronary vulnerability per modifiable RF burden (multivariable): only modifiable RF burden was associated with increased pan-coronary vulnerability
Plaques with a vulnerable phenotype (TCFAs) by number of RFs
- TCFAs increased as the number of RFs increased
- P for trend = 0.001
Number of vulnerable features by number of RFs
- Higher number of vulnerable features
- P for trend < 0.001
- More thin fibrous caps
- P for trend = 0.001
- Lipid-rich plaques (lipid-rich plaques (LRPs)), macrophages, microvessels, and cholesterol crystals
- all P trend ≤ 0.001
Original publication
Association Between Cardiovascular Risk Factors and Pan-Coronary Plaque Burden, Phenotype, and Vulnerability. JACC Adv. Published 23 July 2026. doi:10.1016/j.jacadv.2026.102983
Summarised from the published abstract; every number is checked against it