Optical coherence tomography-derived macrophage arc as a novel biomarker for predicting adverse cardiovascular events in coronary artery disease: a multicentre study
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Abstract Aims Macrophages play a crucial role in coronary artery plaque development and can be quantified as circumferential arc features via optical coherence tomography (OCT). However, the prognostic implications of macrophage arc characteristics remain underexplored. s1 Methods and results In this multicentre, retrospective study, consecutive patients with coronary artery disease (CAD) undergoing OCT between January 2017 and April 2023 were enrolled. The macrophage arc was evaluated using maximum arc, mean arc, and mean arc score (MAS) in the target vessel. Among 1025 patients (1173 vessels), 61 (5.9%) experienced major adverse cardiovascular events (MACEs). Receiver operating characteristic analysis identified optimal predictive thresholds: maximum arc ≥ 157.5°, mean arc ≥ 97.88°, and MAS ≥ 2.27 (all< 0.001). Elevated mean arc [hazard ratio (HR) = 7.628,< 0.0001], maximum arc (HR = 6.902,< 0.0001), and MAS (HR = 6.704,< 0.0001) were independently associated with MACEs. When combined with thin-cap fibroatheroma (TCFA) status, these parameters demonstrated enhanced predictive power: mean arc ≥ 97.88° + TCFA (HR = 8.779,< 0.0001), maximum arc ≥ 157.5° + TCFA (HR = 8.149,< 0.0001), and MAS ≥ 2.27 + TCFA (HR = 7.509,< 0.0001). Notably, among TCFA-negative patients, a mean arc ≥ 97.88° showed markedly improved predictive capacity for MACEs (HR = 6.685,< 0.001), as did maximum arc ≥ 157.5° (HR = 4.490,< 0.001) and MAS ≥ 2.27 (HR = 5.126,< 0.001). s2 Conclusion Macrophage arc par
Abstract
Abstract Aims Macrophages play a crucial role in coronary artery plaque development and can be quantified as circumferential arc features via optical coherence tomography (OCT). However, the prognostic implications of macrophage arc characteristics remain underexplored. s1 Methods and results In this multicentre, retrospective study, consecutive patients with coronary artery disease (CAD) undergoing OCT between January 2017 and April 2023 were enrolled. The macrophage arc was evaluated using maximum arc, mean arc, and mean arc score (MAS) in the target vessel. Among 1025 patients (1173 vessels), 61 (5.9%) experienced major adverse cardiovascular events (MACEs). Receiver operating characteristic analysis identified optimal predictive thresholds: maximum arc ≥ 157.5°, mean arc ≥ 97.88°, and MAS ≥ 2.27 (all< 0.001). Elevated mean arc [hazard ratio (HR) = 7.628,< 0.0001], maximum arc (HR = 6.902,< 0.0001), and MAS (HR = 6.704,< 0.0001) were independently associated with MACEs. When combined with thin-cap fibroatheroma (TCFA) status, these parameters demonstrated enhanced predictive power: mean arc ≥ 97.88° + TCFA (HR = 8.779,< 0.0001), maximum arc ≥ 157.5° + TCFA (HR = 8.149,< 0.0001), and MAS ≥ 2.27 + TCFA (HR = 7.509,< 0.0001). Notably, among TCFA-negative patients, a mean arc ≥ 97.88° showed markedly improved predictive capacity for MACEs (HR = 6.685,< 0.001), as did maximum arc ≥ 157.5° (HR = 4.490,< 0.001) and MAS ≥ 2.27 (HR = 5.126,< 0.001). s2 Conclusion Macrophage arc parameters are strongly associated with long-term cardiovascular risk, serving as novel OCT-derived biomarkers for patients with CAD. s3 Graphical Abstract Graphical Abstract This graphical abstract summarizes a 2017–2023 multicenter retrospective cohort of 1025 patients and 1173 coronary vessels. Three OCT-derived macrophage arc metrics (maximum arc, mean arc, mean arc score [MAS]) are independent predictors of major adverse cardiovascular events (MACEs), with optimized cutoffs and good AUC values validated by adjusted multivariate analysis (all p < 0.001). Kaplan–Meier curves illustrate their prognostic value for long-term MACE-free survival. Limitations include the retrospective design and a requirement for external validation. For image description, please refer to the figure legend and surrounding text. http://www.w3.org/1999/xlink float portrait qyag107_ga.jpg anchor qyag107_ga portrait graphical