Coronary disease & ACSCross-sectional study
Plaque Vulnerability and Cardiovascular Risk Factor Burden in Acute Coronary Syndrome
- Cross-sectional study
Authors' conclusion
In patients with ACS, an increasing number of cardiovascular risk factors were strongly associated with greater plaque vulnerability, especially for culprit lesions.
Study context
- Population
- Patients with acute coronary syndrome (ACS); plaques assessed by optical coherence tomography2,187 plaques analysed
- Exposure
- ≥2 vs 0-1 traditional risk factors
- Outcome
- Plaque vulnerability defined by optical coherence tomography
Main finding
As reported in the abstract
Vulnerable features in culprit plaques by number of risk factors
- Lipid-rich plaques increased with number of risk factors
- P trend = 0.027
- Thin-cap fibroatheromas increased
- P trend = 0.006
- Macrophages increased
- P trend <0.001
- Microvessels increased
- P trend <0.001
- Cholesterol crystals increased
- P trend = 0.032
- Plaque rupture increased
- P trend = 0.015
- Plaque erosion decreased
- P trend <0.001
Observational data: associations, not effects.
Further findings
Nonculprit plaques (606)
- Only macrophages, cholesterol crystals and cumulative number of vulnerable features per plaque significantly positively associated with number of risk factors
Original publication
Plaque Vulnerability and Cardiovascular Risk Factor Burden in Acute Coronary Syndrome. J Am Coll Cardiol. Published 15 July 2025. doi:10.1016/j.jacc.2025.04.070
Summarised from the published abstract; every number is checked against it