Liu Chunwei, Yang Fan, Hu Yuecheng, Wang Le, Li Ximing, Cong Hongliang, Zhang Jingxia
Department of Cardiology, Tianjin Chest Hospital, Tianjin University, Tianjin, China.
Department of Diagnostic Ultrasound, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Front Cardiovasc Med. 2025 Jun 25;12:1625239. doi: 10.3389/fcvm.2025.1625239. eCollection 2025.
Quantitative assessment of macrophage accumulation is appealing in evaluating plaque inflammation. In optical coherence tomography (OCT) imaging, local macrophage clusters may be a feasible marker for macrophage quantification.
404 patients presenting with acute coronary syndrome who underwent OCT evaluation were included. This study aims to assess the relationships between systemic inflammatory biomarkers [including monocytes, high-density lipoprotein cholesterol (HDL-C), and monocyte-to-HDL ratio (MHR)], plaque characteristics, and local macrophage clusters in coronary plaque.
Macrophage clusters were present in 218 patients, with a median arc value of 72° (50°-163°). Patients with macrophage clusters showed markedly higher levels of inflammatory biomarkers and plaque vulnerability. Multivariate logistic regression analysis demonstrated that MHR, lipid index, and microchannel were independently associated with the presence of macrophage clusters. The DeLong test showed the area under the curve of the above three combined indicators was significantly larger than that of single indicators (0.774 vs. 0.692, 0.665, 0.624, respectively, < 0.001). The macrophage cluster arc correlated positively with MHR and lipid index ( = 0.219, = 0.001; and = 0.229, = 0.001, respectively). More superficial macrophage infiltration, thin cap fibroatheromas, plaque rupture, and thinner fibrous cap thickness were observed in the large macrophage cluster group (>72°) compared to the small macrophage cluster group (50°-72°). The macrophage cluster arc in the low MHR + lipid index group was significantly lower than that in the high MHR + lipid index group (68° ± 17° vs. 84° ± 26°, = 0.001). Multiple linear regression analysis demonstrated that MHR, age, and lipid index were independently associated with macrophage cluster arc. In subgroup analysis stratified by clinical presentation and high-sensitivity C-reactive protein level, higher MHR and lipid index levels were observed in large macrophage clusters than in the non-macrophage cluster group, irrespective of the inflammation background.
The macrophage cluster was a valuable index for quantifying local plaque inflammation. MHR, lipid index, and microchannel were independently associated with macrophage clusters. Large macrophage clusters were independently associated with high MHR and high lipid plaque burden.
巨噬细胞积聚的定量评估在评估斑块炎症方面具有吸引力。在光学相干断层扫描（OCT）成像中，局部巨噬细胞簇可能是巨噬细胞定量的一个可行标志物。
纳入404例接受OCT评估的急性冠状动脉综合征患者。本研究旨在评估全身炎症生物标志物[包括单核细胞、高密度脂蛋白胆固醇（HDL-C）和单核细胞与HDL比值（MHR）]、斑块特征与冠状动脉斑块中局部巨噬细胞簇之间的关系。
218例患者存在巨噬细胞簇，中位弧值为72°（50°-163°）。有巨噬细胞簇的患者炎症生物标志物水平和斑块易损性明显更高。多因素逻辑回归分析表明，MHR、脂质指数和微通道与巨噬细胞簇的存在独立相关。DeLong检验显示，上述三个联合指标的曲线下面积显著大于单个指标（分别为0.774对0.692、0.665、0.624，P<0.001）。巨噬细胞簇弧与MHR和脂质指数呈正相关（分别为r=0.219，P=0.001；r=0.229，P=0.001）。与小巨噬细胞簇组（50°-72°）相比，大巨噬细胞簇组（>72°）观察到更浅表的巨噬细胞浸润、薄帽纤维粥样斑块、斑块破裂和更薄的纤维帽厚度。低MHR+脂质指数组的巨噬细胞簇弧明显低于高MHR+脂质指数组（68°±17°对84°±26°，P=0.001）。多因素线性回归分析表明，MHR、年龄和脂质指数与巨噬细胞簇弧独立相关。在按临床表现和高敏C反应蛋白水平分层的亚组分析中，无论炎症背景如何，大巨噬细胞簇中的MHR和脂质指数水平均高于非巨噬细胞簇组。
巨噬细胞簇是量化局部斑块炎症的一个有价值指标。MHR、脂质指数和微通道与巨噬细胞簇独立相关。大巨噬细胞簇与高MHR和高脂斑块负荷独立相关。
