Gong Yanyan, Zhao Chen, Jia Lixin, Qiao Bokang, Tian Jinwei, Wen Haichu, Wang Yuan, Yu Bo, Du Jie
Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Centre for Cardiovascular Disorders, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
J Cardiovasc Transl Res. 2025 Jun 20. doi: 10.1007/s12265-025-10646-7.
The objective of this study was to identify plasma lipid signatures associated with plaque vulnerability. We retrospectively evaluated coronary plaque in 99 patients using optical coherence tomography (OCT) and quantified 489 plasma lipids. We identified intra- and inter-class crosstalk among ceramide (Cer)-phosphatidylinositol (PI)-esterified cholesterol (CE)-sphingomyelin (SM) (Cer-PI-CE-SM) in patients with thin-cap fibroatheroma (TCFA). CE-16:0, SM d18:1/16:1, and GM3 d18:1/22:0, emerged as potential markers of TCFA, correlating with the thinnest fibrous cap thickness and the presence of cholesterol crystallization. Compared to the clinical model (area under the curve [AUC] = 0.810), the AUC of the combined clinical-lipid model improved [AUC = 0.880, p = 0.032]. Calibration and decision curves demonstrated that the combined model exhibited superior diagnostic performance. We identified lipid molecules that are strongly correlated with plaque vulnerability, thus providing an option for the non-invasive identification of vulnerable plaques, which could potentially facilitate the tailored treatment for high-risk patients.
本研究的目的是识别与斑块易损性相关的血浆脂质特征。我们使用光学相干断层扫描（OCT）对99例患者的冠状动脉斑块进行了回顾性评估，并对489种血浆脂质进行了定量分析。我们在薄帽纤维粥样斑块（TCFA）患者中发现了神经酰胺（Cer）-磷脂酰肌醇（PI）-酯化胆固醇（CE）-鞘磷脂（SM）（Cer-PI-CE-SM）之间的类内和类间串扰。CE-16:0、SM d18:1/16:1和GM3 d18:1/22:0成为TCFA的潜在标志物，与最薄的纤维帽厚度和胆固醇结晶的存在相关。与临床模型（曲线下面积[AUC]=0.810）相比，联合临床-脂质模型的AUC有所提高[AUC=0.880，p=0.032]。校准曲线和决策曲线表明联合模型具有更好的诊断性能。我们识别出了与斑块易损性密切相关的脂质分子，从而为无创识别易损斑块提供了一种选择，这可能有助于为高危患者制定个性化治疗方案。
