Aortic & peripheral vascular disease
Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy
Authors' conclusion
Together, these findings provide critical insights into the functional differences and origin of macrophage subpopulations in human atherosclerosis and show their clinical significance and risk prediction value in relation to future cardiovascular events.
Study context
- Population
- Patients undergoing carotid endarterectomy (AtheroExpress cohort; validation in the Carotid Plaque Imaging Project)46 scRNA-seq
- Outcome
- MACE
- Follow-up
- 3-year follow-up
Methodological detailssingle-cell RNA sequencing, bulk transcriptome deconvolution, external validation cohort
- Single-cell RNA sequencing
- Bulk transcriptome deconvolution
- External validation cohort
Main finding
As reported in the abstract
- Four major plaque macrophage archetypes identified: inflammatory macrophages, lipid-associated macrophages (LAMs), tissue-resident-like LAMs, inflammatory LAMs
- Macrophages the only cell population significantly associated with both symptoms at surgery and increased MACE risk during 3-year follow-up
- LAM and inflammatory LAM foam cell markers (e.g. PLIN2, TREM1) associated with increased MACE risk after 3-year follow-up
- Associations validated in the Carotid Plaque Imaging Project cohort
Further findings
Macrophage origin
- Derived from both classical and non-classical monocytes; monocytes can differentiate into inflammatory LAMs via inflammatory- or resident-like LAM and LAM stages
Original publication
Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy. Eur Heart J. Published 27 February 2026. doi:10.
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