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Atherosclerosis. 2015 Dec;243(2):560-6. doi: 10.1016/j.atherosclerosis.2015.10.022. Epub 2015 Oct 23.

Plasma concentrations of molecular lipid species in relation to coronary plaque characteristics and cardiovascular outcome: Results of the ATHEROREMO-IVUS study.

Author information

1
Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardiovascular Research School Erasmus University Rotterdam, Rotterdam, the Netherlands; ICIN Netherlands Heart Institute, Utrecht, the Netherlands.
2
Zora Biosciences, Espoo, Finland.
3
Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardiovascular Research School Erasmus University Rotterdam, Rotterdam, the Netherlands.
4
Cardialysis, Rotterdam, the Netherlands.
5
Department of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany.
6
Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardialysis, Rotterdam, the Netherlands; Imperial College, International Center of Circulatory Health, London, United Kingdom.
7
Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardiovascular Research School Erasmus University Rotterdam, Rotterdam, the Netherlands. Electronic address: h.boersma@erasmusmc.nl.
8
Zora Biosciences, Espoo, Finland; University Hospital, Tampere, Finland; Medical School University of Tampere, Finland. Electronic address: reijo.laaksonen@zora.fi.

Abstract

BACKGROUND AND AIMS:

Previous lipidomics analyses have demonstrated that several lipid molecules in plasma are associated with fatal outcome in patients with coronary artery disease (CAD). This study aims to investigate the associations of previously identified high risk lipid molecules in plasma with coronary plaque characteristics derived from intravascular ultrasound virtual histology (IVUS-VH) imaging, with coronary lipid core burden index (LCBI) on near-infrared spectroscopy (NIRS), and with one year cardiovascular outcome in patients with CAD.

METHODS:

Between 2008 and 2011, IVUS-VH imaging of a non-culprit coronary artery was performed in 581 patients who underwent coronary angiography for acute coronary syndrome (ACS) or stable CAD. NIRS imaging was additionally performed in 191 patients. Plasma concentrations of molecular lipids were measured with mass spectrometry.

RESULTS:

Several cholesteryl ester, ceramide and lactosylceramide species and ceramide ratios were associated with vulnerable plaque characteristics on IVUS-VH and NIRS imaging and with 1-year major adverse cardiac events (MACE, defined as all-cause mortality, ACS and unplanned coronary revascularization). In particular, ceramide d18:1/16:0 was consistently associated with higher necrotic core fraction on IVUS-VH (p = 0.001), higher LCBI (p = 0.024) on NIRS and higher MACE rate (adjusted HR 1.79 per standard deviation increase in log-transformed lipid concentration, 95%CI 1.24-2.59, p = 0.002).

CONCLUSION:

Several molecular lipid species, and particularly ceramide(d18:1/16:0), are associated with the fraction of necrotic core tissue and lipid core burden in coronary atherosclerosis, and are predictive for 1-year clinical outcome after coronary angiography. These molecular lipids may improve risk stratification in CAD and may also be interesting therapeutic targets for the treatment of atherosclerotic disease.

KEYWORDS:

Atherosclerosis; Intravascular ultrasound; Lipids; Near-infrared spectroscopy; Prognosis

[Indexed for MEDLINE]

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