Association of circulating levels of neopterin with non-culprit plaque vulnerability in CAD patients an angiogram, optical coherent tomography and intravascular ultrasound study

Abstract

BackgroundNeopterin is a pteridine derivative secreted by activated macrophages. Previous studies have shown that neopterin plays a pivotal role in coronary artery disease (CAD); however, the relationship between circulating neopterin and non-culprit plaque vulnerability in patients with CAD remains unclear. In this study, we investigated the correlation of neopterin and vulnerable plaque features in patients with CAD. MethodsOne hundred and thirty non-culprit plaques from 81 patients with CAD were assessed by angiogram and optical coherence tomography (OCT) as well as intravascular ultrasound (IVUS) imaging. According to the median value of serum neopterin (10.61 nmol/L), patients were divided into a low neopterin group (n = 40, <median) and a high neopterin group (n = 41, ≥median). Plaque characteristics were compared between the two groups. ResultsCompared with the low neopterin group, OCT findings showed that patients in the high neopterin group had thinner fibrous cap thickness (FCT) (90.02 ± 52.96 μm vs. 124.69 ± 65.23 μm, P = 0.004) and more thin-cap fibroatheroma (TCFA) (38.0% vs. 13.6%, P = 0.002). Microvessel and plaque rupture were more frequently observed in the high neopterin group (P = 0.004 and P = 0.005, respectively). IVUS findings showed that plaque burden was greater in the high neopterin group than that in the low neopterin group (P = 0.005). ConclusionsNeopterin was positively associated with vulnerable plaque features including TCFA, thinner fibrous cap, plaque rupture, greater plaque burden and frequent microvessel occurrence in CAD patients.