Correlation between lipidic content and arterial-wall plaque burden: A Lipid Rich Plaque study sub-analysis.

BACKGROUND

Large plaque burden (PB) has been linked to adverse coronary events. We sought to assess the correlation between lipidic content and arterial PB within the Lipid Rich Plaque (LRP) study.

METHODS

This analysis included 1269 patients and 5743 coronary segments with both evaluable Lipid Core Burden Index (maxLCBI) and PB. Non-culprit major adverse cardiac events (NC-MACE; defined as a composite of cardiac death, cardiac arrest, non-fatal myocardial infarction, acute coronary syndrome, revascularization, and hospital readmission for angina with progressive stenosis) were assessed by hazard ratios (HR) at 2 years.

RESULTS

NC-MACE for segment cohorts in the most vulnerable quadrant of maxLCBI > 400 and PB >40% was the highest (HR, 3.78 [95% confidence interval (CI) 2.39-5.66]) with similar rates for just PB >40% (HR 1.31 [95% CI 0.81-2.02]) and just maxLCBI > 400 (HR 1.11 [95% CI 0.10-5.38]). Fewer events occurred in the maxLCBI ≤ 400 and PB ≤40% quadrant (HR 0.25 [95% CI 0.11-0.50]).

CONCLUSIONS

Coronary segments with high lipid content but no measurable PB were still associated with events at 2 years. NC-MACE vulnerability increased as the lipidic content and PB increased, with the highest incidence within segments having maxLCBI > 400 and plaque >40%.

CLINICAL TRIAL REGISTRATION

The Lipid-Rich Plaque Study (LRP), NCT02033694, https://clinicaltrials.gov/ct2/show/NCT02033694.