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

Abstract

BackgroundLarge 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. MethodsThis analysis included 1269 patients and 5743 coronary segments with both evaluable Lipid Core Burden Index (maxLCBI4mm) 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. ResultsNC-MACE for segment cohorts in the most vulnerable quadrant of maxLCBI4mm > 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 maxLCBI4mm > 400 (HR 1.11 [95% CI 0.10–5.38]). Fewer events occurred in the maxLCBI4mm ≤ 400 and PB ≤40% quadrant (HR 0.25 [95% CI 0.11–0.50]). ConclusionsCoronary 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 maxLCBI4mm > 400 and plaque >40%. Clinical trial registrationThe Lipid-Rich Plaque Study (LRP), NCT02033694, https://clinicaltrials.gov/ct2/show/NCT02033694.