Abstract P193: Increased High Density Lipoprotein Cholesterol:ApolipoproteinA1 Ratio is Associated with Less Progression of Coronary Atherosclerosis in Statin-Treated Patients

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Preethi Mani ◽  
Kiyoko Uno ◽  
Julie Thornton ◽  
Stephen Nicholls
Keyword(s):  
Coronary Atherosclerosis ◽  
Coronary Plaque ◽  
Cholesterol Content ◽  
Favorable Effect ◽  
Plaque Burden ◽  
P Value ◽  
Plaque Progression ◽  
Coronary Syndrome ◽  
Hdl Function ◽  
Atheroma Volume

Background HDL cholesterol (HDL-C) and apolipoprotein AI (apoAI) levels are inversely related to adverse cardiovascular outcome. Associations between these HDL related measures and their ratio with coronary plaque progression have not been studied. It has been proposed that increasing HDL particle cholesterol content impairs HDL function, but impact on disease progression is unknown. We hypothesize that all HDL related measures are inversely associated with coronary plaque progression. Methods Retrospective analysis was performed of 1528 statin treated patients with angiographic CAD who had serial evaluation of atheroma burden with intravascular ultrasound. Relationships between achieved levels of HDL related measures with clinical characteristics and changes in plaque burden were determined. Results Strong correlation between HDL-C and apoAI (r=0.73, p<0.0001) was noted. Patients with highest levels of HDL-C:apoAI were more likely to be female, black, and have lower BMI and less likely to be smokers or have previous revascularization (all p<0.001) or acute coronary syndrome (p=0.013). HDL-C, apoAI, and HDL-C:apoAI demonstrated negative correlation with change in total atheroma volume (p<0.01). For HDL-C:apoAI and HDL-C, increasing tertiles of achieved levels were associated with a linear benefit in slowing progression. For apoAI, a nonlinear association was seen, with similar benefit on progression in the middle and upper tertiles ( Table ). There was no statistical interaction for heterogeneity between HDL-C:apoAI and atheroma burden based on achieved levels of HDL-C (p=0.581). Change in IVUS Measures By Tertiles of Achieved HDL-related Parameters Percent Atheroma Volume Parameter T1 T2 T3 P Value HDL-C 0.58±0.27 0.26±0.27 0.11±0.27 0.012 ApoAI 0.28±0.26 −0.04±0.26 −0.08±0.26 0.10 HDL-C:ApoAI 0.22±0.27 0.13±0.27 −0.27±0.27 0.021 Total Atheroma Volume Parameter T1 T2 T3 P Value HDL-C −2.46±2.21 −4.18±2.20 −5.31±2.20 0.035 ApoAI −4.94±2.13 −6.30±2.13 −7.40±2.13 0.135 HDL-C:ApoAI −4.59±2.25 −6.38±2.24 −8.07±2.26 0.022 Conclusions Increase in all HDL related measures was associated with less progression of coronary atherosclerosis. Association of higher HDL-C:ApoAI with favorable effect on plaque progression at all levels of HDL-C suggests intact HDL functionality of larger cholesterol rich particles. Interventions that increase HDL particle cholesterol content, such as CETP inhibitors, may thus have beneficial effect at the artery wall.

Evaluation of human coronary vasodilator function predicts future coronary atheroma progression

Heart ◽  
2018 ◽  
Vol 104 (17) ◽  
pp. 1439-1446 ◽  
Author(s):  
Samuel L Sidharta ◽  
Timothy J Baillie ◽  
Stuart Howell ◽  
Stephen J Nicholls ◽  
Natalie Montarello ◽  
...  
Keyword(s):  
Near Infrared ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Plaque Progression ◽  
Independent Function ◽  
Lipid Core ◽  
Coronary Syndrome ◽  
Coronary Vasodilator ◽  
Dependent Function ◽  
The Relationship

ObjectiveCoronary vasodilator function and atherosclerotic plaque progression have both been shown to be associated with adverse cardiovascular events. However, the relationship between these factors and the lipid burden of coronary plaque remains unknown. These experiments focus on investigating the relationship between impaired coronary vasodilator function (endothelium dependent (salbutamol) and endothelium independent (glyceryl trinitrate)) and the natural history of atheroma plaque progression and lipid burden using dual modality intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) imaging.Methods33 patients with stable chest pain or acute coronary syndrome underwent serial assessment of coronary vasodilator function and intracoronary plaque IVUS and NIRS imaging. Coronary segmental macrovascular response (% change segmental lumen volume (ΔSLV)), plaque burden (per cent atheroma volume (PAV)), lipid core (lipid-rich plaque (LRP) and lipid core burden index (LCBI)) were measured at baseline and after an interval of 12–18 months (n=520 segments).ResultsLipid-negative coronary segments which develop into LRP over the study time period demonstrated impaired endothelial-dependent function (−0.24±2.96 vs 5.60±1.47%, P=0.04) and endothelial-independent function (13.91±4.45 vs 21.19±3.19%, P=0.036), at baseline. By multivariate analysis, endothelial-dependent function predicted ∆LCBI (β coefficient: −3.03, 95% CI (−5.81 to −0.25), P=0.033) whereas endothelial-independent function predicted ∆PAV (β coefficient: 0.07, 95% CI (0.04 to 0.10), P<0.0001).ConclusionsEpicardial coronary vasodilator function is a determinant of future atheroma progression and composition irrespective of the nature of clinical presentation.Trial registration numberACTRN12612000594820, Post-results.

Abstract 15270: Coronary Plaque Natural History Displays Marked Longitudinal Heterogeneity Along the Length of Individual Coronary Plaques

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jolanda J Wentzel ◽  
Michail I Papafaklis ◽  
Antonios Antoniadis ◽  
Saeko Takahashi ◽  
Nicholas V Cefalo ◽  
...  
Keyword(s):  
Shear Stress ◽  
Natural History ◽  
Coronary Arteries ◽  
Mixed Model ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Plaque Progression ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Maximal Wall Thickness

Introduction: Plaque natural history is related to local shear stress, and shear stress has been shown to be heterogeneously distributed along the length of individual plaques. We investigated the longitudinal spatial heterogeneity of plaque progression/regression/quiescence in human coronary arteries. Methods: 591 coronary arteries from 302 patients with coronary disease who presented with an acute coronary syndrome from the PREDICTION study were investigated for local plaque progression/regression/quiescence patterns in non-culprit plaques after 6-10 month FU. Arterial geometry was derived from angiography/IVUS-based vascular profiling and reported in 3 mm segments. Plaques were defined as >3 consecutive segments with maximal wall thickness>0.5 mm. Plaque progression was defined as >5% increase, regression as <-5% decrease, and quiescence as no change in plaque burden (plaque area/ total vessel area * 100%). Results: 5658 3mm-segments of 661 plaques were analyzed. Plaque burden changes ranged from -22% to +20%. Among all plaques, 56% showed segments with plaque progression, 60% with regression and 96% with quiescence. On average, 17% of the plaque length displayed plaque progression, 20% regression and 63% quiescence. The presence and number of natural history features (progression, regression, quiescence) within the individual plaques were significantly related to plaque length using logistic mixed model regression analysis (figure). Conclusions: Coronary plaque natural history is extremely heterogeneous along the length of an individual plaque. These observations may explain why revascularization of a focal severe obstruction in the ISCHEMIA trial did not affect clinical outcomes, since remaining high-risk plaque up- or down-stream from the revascularization may have led to future cardiac events.

Abstract 681: Characteristics of Atherosclerotic Plaque Burden in Patients With and Without Acute Coronary Syndrome Presenting With Acute Chest Pain to the Emergency Department

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fabian Bamberg ◽  
Maros Ferecik ◽  
Quynh Truong ◽  
Ian Rogers ◽  
Michael Shapiro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Coronary Arteries ◽  
Atherosclerotic Plaque ◽  
Acute Chest Pain ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Coronary Syndrome ◽  
Coronary Ct ◽  
Calcified Plaque

Background: Coronary computed tomography (CT) may improve the early triage of patients with acute chest pain in the emergency department (ED). The aim of this study was to compare the presence and extent of coronary atherosclerotic plaque as detected by coronary CT in patients with and without acute coronary syndromes (ACS). Methods: The study was designed as a prospective, observational cohort study in patients with acute chest pain but negative cardiac biomarkers and no diagnostic ECG changes, admitted to rule out myocardial ischemia. All patients underwent coronary CT prior to hospital admission. The presence of coronary plaque was treated as a dichotomous outcome, and the extent of CAD was defined as number of (1) coronary segments with plaque, or (2) major coronary arteries with plaque detected by MDCT as assessed by two independent observers. The clinical outcome (ACS) was adjudicated by a review committee using established AHA criteria; subjects with history of CAD (stent placement, bypass) were excluded. Results : Among 368 patients with acute chest pain (mean age 53±12 years, 61% male) 31 patients were determined to have ACS (8%). None of the 183 subjects without plaque (50%) had an ACS. Among the remaining 185 subjects (mean age 58.0±11.5 years, 68% male) in whom coronary plaque was detected, patients with ACS had a significantly more plaque (7.2±3.7 vs. 4.2±3.4, p<0.0001 segments) as compared to subjects without ACS. Similar results were seen for calcified plaque and non-calcified plaque (6.5±3.7 vs. 3.6±3.5 segments, p<0.0001; and 3.6±3.2 vs. 1.8±2.2 segments, p<0.0001, respectively). In addition, the rate of ACS increased with the number of major coronary arteries with plaque (1-vessel: 6.8%, 2-vessels: 10.6%, 3 vessels: 30.8%, and 4-vessels: 25%; p<0.01). In contrast, the ratio of non-calcified to calcified plaque was not different between patients with and without ACS (0.68±0.6 vs. 0.54±0.72, p=0.31). Conclusions: The extent of coronary plaque differs between subjects with and without ACS among patients presenting with acute chest pain. Detailed assessment of the extent and composition of coronary plaque may be helpful to assess risk of ACS among patients with acute chest pain but inconclusive initial ED evaluation.

Abstract 11885: Differential Contributions of Abdominal Visceral Fat and Epicardial Fat to Coronary Atherosclerosis in Non-Obese Japanese Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ken Harada ◽  
Takashi Kataoka ◽  
Masahiro Takeshita ◽  
Kazuhiro Harada ◽  
Ayako Kunimura ◽  
...  
Keyword(s):  
Visceral Fat ◽  
Coronary Atherosclerosis ◽  
Japanese Patients ◽  
Coronary Plaque ◽  
Epicardial Fat ◽  
Systemic Effects ◽  
Visceral Fat Area ◽  
Coronary Syndrome ◽  
Abdominal Visceral Fat ◽  
Noncalcified Plaque

Introduction: Epicardial fat is a source of adipocytokines that have both paracrine and systemic effects and is implicated in coronary atherosclerosis. The relation between epicardial fat volume (EFV) and circulating adipocytokine levels has remained unknown, however. Objectives: We assessed the relation between EFV and both plasma adipocytokine concentrations and coronary atherosclerotic plaque. Methods: Consecutive Japanese patients suspected of having coronary artery disease (n = 216) were examined. Individuals with acute coronary syndrome or with inadequate CT imaging were excluded. A total of 164 patients (65 ± 10 years; 70% men; BMI, 23.8 ± 3.6 kg/m2) was enrolled. Plasma levels of adiponectin, interleukin-6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), and vascular endothelial growth factor (VEGF) were measured. The characteristics of coronary plaque, abdominal visceral fat area, and EFV were determined by 64-slice CT. Results: EFV was greater in subjects with noncalcified plaque than in those with no plaque or with calcified plaque (126 ± 39 vs. 98 ± 34 and 97 ± 45 mL, respectively; P = 0.010). EFV was significantly correlated with BMI, plasma triglyceride concentration, and the triglyceride/HDL-cholesterol ratio (r = 0.51, 0.19, and 0.20, respectively) but not with plasma adipocytokine levels, whereas plasma adiponectin and IL-6 levels were significantly correlated (r = -0.49 and 0.20, respectively) with visceral fat area, in patients with coronary plaque. Conclusions: Patients with noncalcified plaque had increased EFV but their plasma adipocytokine levels had not increased. Adipocytokines in plasma may be derived mainly from abdominal visceral fat, whereas epicardial fat may promote coronary atherosclerosis directly through a paracrine mechanism rather than by systemic effects. In conclusion, abdominal visceral fat and epicardial fat may thus contribute to coronary atherosclerosis by distinct mechanisms in nonobese individuals.

Abstract 549: Visceral Adipose Tissue Associates With Coronary Plaque Burden Beyond Cardiovascular Risk Factors in Psoriasis

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Joshua P Rivers ◽  
Amit K Dey ◽  
Jonathan H Chung ◽  
Anshuma Rana ◽  
Abhishek Chaturvedi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adipose Tissue ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Plaque ◽  
Human Model ◽  
Plaque Burden ◽  
P Value ◽  
Adipose Tissue Dysfunction ◽  
Beta Coefficient

Background: Psoriasis (PSO), a chronic inflammatory disease associated with increased cardiovascular (CV) risk, provides a reliable human model to study inflammatory atherogenesis. PSO has been known to be associated with cardiometabolic dysfunction including adipose tissue dysfunction. Recently, visceral adiposity (VAT) was shown to be associated with increased CV events, but whether VAT is associated with subclinical atherosclerosis as assessed by coronary plaque burden has not been characterized. Hypothesis: We hypothesized that VAT volume by CT is associated with total burden (TB) and more specifically with non-calcified burden (NCB) by CCTA. Methods: Consecutive PSO patients (N=68) underwent CT scans to measure abdominal adiposity. VAT volume was quantified from the level of the diaphragm to the pubic symphysis and reported in volume. Coronary plaque characterization was performed by CCTA (Toshiba 30 slice) via QAngio CT software (Medis, The Netherlands). The relationship of VAT with TB and NCB was analyzed using unadjusted and adjusted multivariable regression models (STATA 12). Results: The cohort was middle-aged, predominantly male, at low CV risk by FRS with mild to moderate PSO by skin disease severity (Table 1). VAT volume associated with both TB (beta coefficient= 0.49, p-value <0.001) and NCB (beta coefficient= 0.51, p-value <0.001). This relationship remained significant after adjustment for cardiovascular risk factors for TB (beta coefficient= 0.28, p-value = 0.004) and NCB (beta coefficient = 0.34, p-value <0.001). Conclusions: Directly quantified VAT directly associated with TB and NCB independent of cardiovascular risk factors. These findings suggest that adipose tissue dysfunction may in part contribute to the high CV events observed in psoriasis and support efforts to provide weight control as a strategy to reduce CV disease in psoriasis.

scholarly journals Serum cholesterol efflux capacity is associated with coronary plaque progression in patients with coronary heart disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
X Q Wang ◽  
S Feng ◽  
X Y Shu ◽  
C D Yang ◽  
R Y Zhang
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Angiography ◽  
Cholesterol Efflux ◽  
Hdl Cholesterol ◽  
Coronary Plaque ◽  
Plaque Progression ◽  
Cholesterol Efflux Capacity ◽  
Hdl Function

Abstract Background Coronary plaque progression is a major risk factor of adverse cardiac events in patients with coronary heart disease (CHD). Emerging evidence showed that attenuated high-density lipoprotein (HDL) function measured by cholesterol efflux capacity (CEC) was associated with development of atherosclerosis independent of HDL cholesterol level. In this study, we sought to investigate whether CEC is a predictor for coronary plaque progression in CHD patients. Methods We consecutively enrolled CHD patients from January 2017 to August 2019 in our Hospital who underwent elective percutaneous coronary intervention and had at least one non-target coronary lesion. Follow-up coronary angiography were performed at around 12 months. Fluorescence-labeled cholesterol and J774 macrophages were used to measure the CEC of ApoB-depleted serum sample from all patients. Quantitative coronary angiography (QCA) was performed both at baseline and follow-up to analyze the plaque progression. Results A total of 430 CHD patients with 586 non-target coronary lesions were included in the final analysis. During a mean follow-up time of 381.04±59.52 days, patients with decreased CEC presented more severe plaque progression (net luminal loss in highest to lowest CEC quartile: 0.22±0.42mm vs 0.20±0.41mm vs 0.13±0.36mm vs 0.11±0.34mm, p=0.035). In multivariate analysis, baseline CEC was independently associated with coronary plaque progression after adjustment for traditional risk factors including HDL cholesterol and ApoA-I, no matter treated as categorical variable (OR: 0.382 [95% CI 0.180–0.781] for highest to lowest quartile) or continuous variable (OR: 0.522 [95% CI 0.373–0.714] for per SD increase]. Furthermore, CEC demonstrated a better power in predicting coronary plaque progression compared with HDL cholesterol concentration (AUC=0.644 vs 0.514). Conclusions This study suggests that HDL function reflected by serum CEC is an independent predictor for coronary plaque progression in CHD patients. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China, Shanghai Municipal Commission of Health and Family Planning

scholarly journals 18: IMPROVEMENT IN PSORIASIS SKIN DISEASE SEVERITY IS ASSOCIATED WITH REDUCTION OF CORONARY PLAQUE BURDEN

2016 ◽  
Vol 64 (3) ◽  
pp. 814.1-814 ◽  
Author(s):  
JB Lerman ◽  
AA Joshi ◽  
J Rodante ◽  
T Aberra ◽  
MT Kabbany ◽  
...  
Keyword(s):  
Severity Index ◽  
Coronary Plaque ◽  
Longitudinal Change ◽  
Human Model ◽  
Plaque Burden ◽  
Categorical Variables ◽  
P Value ◽  
Longitudinal Impact ◽  
Psoriasis Area Severity Index

Purpose of StudyPsoriasis (PSO), a chronic inflammatory disease associated with increased cardiovascular (CV) risk, provides a clinical human model to study inflammatory atherogenesis. While PSO severity is associated with both in vivo vascular disease and future CV risk, the longitudinal impact of PSO severity on coronary disease progression is unknown. We hypothesized that an improvement in PSO severity may lead to a reduction in coronary plaque burden by coronary CT angiography (CCTA).Methods UsedConsecutively recruited PSO patients (N=50) underwent CCTA (320 detector row, Toshiba) and cardiometabolic profiling at baseline and 1-year follow-up. Total (TB) and non-calcified (NCB) coronary plaque burden were quantified using QAngio (Medis, Netherlands). PSO severity was measured as the psoriasis area severity index (PASI). The longitudinal change in coronary plaque burden was analyzed with unadjusted and adjusted regression.Summary of ResultsThe cohort had a low Framingham Risk Score and mild to moderate PSO. Patients whose PSO severity improved (ΔPASI −27%; p<0.001) (N=33) had significant improvement in TB (β=0.40, p=0.003) and NCB (β=0.49, p<0.001) (table 1), beyond adjustment for traditional CV risk factors, BMI, statin use, & systemic/biologic PSO therapy.ConclusionsImprovement in PSO severity was associated with improvement in coronary plaque burden by CCTA. Our study suggests that a reduction in skin inflammation may reduce the progression of early, non-calcified coronary plaque. Larger studies are needed to confirm these findings.Abstract 18 Figure 1*P-value is calculated by comparing baseline and 1-year follow-up values for variables using paired t-test for continuous variables, and Pearson's chi-squared test for categorical variables. All values are expressed as Mean±SD, unless specified otherwise. PASI: Psoriasis Area Severity Index.

Abstract 12156: Greater Regression of Coronary Atherosclerosis With the Pre-Beta High-Density Lipoprotein Mimetic CER-001 in Patients With More Extensive Plaque Burden

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yu Kataoka ◽  
Jordan Andrews ◽  
MyNgan Duong ◽  
Tracy Nguyen ◽  
Nisha Schwarz ◽  
...  
Keyword(s):  
High Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Density ◽  
Plaque Burden ◽  
Operating Characteristics ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Imaging Characteristics ◽  
Atheroma Volume ◽  
Plaque Regression

Introduction: Infusing high-density lipoprotein (HDL) has been shown to promote plaque regression in patients with acute coronary syndrome (ACS). The factors associated with a greater propensity to regression have not been elucidated. We hypothesized greater plaque regression with HDL infusion would be observed in patients with greater baseline plaque burden. Methods: The CHI-SQUARE study compared the effect of infusing the pre-beta HDL mimetic CER-001 (3 to 12 mg/kg) versus placebo weekly for 5 weeks in patients with a recent ACS on plaque burden using serial intravascular ultrasound. Receiver operating characteristics curve analysis determined that a baseline percent atheroma volume (PAV) ≥30% optimally associated with greater regression. Clinical and imaging characteristics were compared in patients with baseline PAV <30% (n=74) or ≥30% (n=271). Results: There were no differences between the groups apart from greater use of statin in patients with baseline PAV ≥30% (100 v. 90%, p=0.01). Patients with a greater baseline PAV were more likely to demonstrate echolucency (20 v. 9%, p=0.02) and ultrasound attenuation (21 v. 7%, p=0.01), consistent with lipidic and inflammatory material. On serial evaluation, PAV decreased with CER-001 infusion in patients with baseline PAV ≥30% by -0.27% (p=0.01 v. baseline), but not in those with baseline PAV <30% (+0.43%, p=0.15 v. baseline, p=0.01 between plaque burden groups). The greatest PAV regression was observed with infusing CER-001 3 mg/kg in patients with baseline PAV ≥30% by 0.96% (p=0.04 v. baseline, p=0.02 v. placebo) (Table), but not in those patients with baseline PAV <30% (+0.08%, p=0.55 v. baseline, p=0.004 for comparison between plaque burden groups). Conclusions: Greater plaque regression with CER-001 3 mg/kg was observed in ACS patients with greater atheroma burden and more vulnerable features. The findings identify ACS patients with high-risk plaque features most likely to benefit from HDL mimetic therapy.

scholarly journals Variability of the Plasma Lipidome and Subclinical Coronary Atherosclerosis

2021 ◽  
Author(s):  
Sock Hwee Tan ◽  
Hiromi W.L. Koh ◽  
Jing Yi Chua ◽  
Bo Burla ◽  
Ching Ching Ong ◽  
...  
Keyword(s):  
Risk Score ◽  
Coronary Atherosclerosis ◽  
Framingham Risk Score ◽  
Coronary Plaque ◽  
High Variability ◽  
Plaque Burden ◽  
Plaque Volume ◽  
Framingham Risk ◽  
Coronary Events ◽  
Noncalcified Plaque

Objective: While the risk of acute coronary events has been associated with biological variability of circulating cholesterol, the association with variability of other atherogenic lipids remains less understood. We evaluated the longitudinal variability of 284 lipids and investigated their association with asymptomatic coronary atherosclerosis. Approach and Results: Circulating lipids were extracted from fasting blood samples of 83 community-sampled symptom-free participants (age 41–75 years), collected longitudinally over 6 months. Three types of coronary plaque volume (calcified, lipid-rich, and fibrotic) were quantified using computed tomography coronary angiogram. We first deconvoluted between-subject (CV g ) and within-subject (CV w ) lipid variabilities. We then tested whether the mean lipid abundance was different across groups categorized by Framingham risk score and plaques phenotypes (lipid-rich, fibrotic, and calcified). Last, we investigated whether visit-to-visit variability of each lipid was associated with plaque burden. Most lipids (72.5%) exhibited higher CV g than CV w . Among the lipids (N=145) with 1.2-fold higher CV g than CV w , 26 species including glycerides and ceramides were significantly associated with Framingham risk score and the 3 plaque phenotypes (false discovery rate <0.05). In an exploratory analysis of person-specific visit-to-visit variability without multiple-comparisons testing, high variability of 3 lysophospholipids (lysophosphatidylcholines 16:0, 18:0, and O-18:1) were associated with lipid-rich and fibrotic (noncalcified) plaque volume while high variability of diacylglycerol 18:1_20:0, triacylglycerols 52:2, 52:3, and 52:4, ceramide d18:0/20:0, dihexosylceramide d18:1/16:0, and sphingomyelin 36:3 were associated with calcified plaque volume. Conclusions: High person-specific longitudinal variation of specific nonsterol lipids are associated with the burden of subclinical coronary atherosclerosis. Larger studies are needed to confirm these exploratory findings.

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