ArticleJACC. Advances2026
Association Between Cardiovascular Risk Factors and Pan-Coronary Plaque Burden, Phenotype, and Vulnerability: A 3-Vessel Imaging Study.
Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01110538 (The Massachusetts General Hospital Optical Coherence Tomography Registry), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Massachusetts General Hospital Optical Coherence Tomography Registry
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9 authors.
Funding
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Abstract
backgroundCardiovascular risk factors (RFs) are commonly used in clinical practice to predict future adverse cardiovascular outcomes, including acute coronary syndromes (ACS). A recent study reported an association between RFs and plaque vulnerability in patients with ACS.
objectivesThis study aimed to investigate the association between RFs (modifiable and non-modifiable) and pan-coronary plaque burden, plaque phenotype, and features of vulnerability.
methodsIn patients undergoing 3-vessel optical coherence tomography imaging, modifiable (dyslipidemia, hypertension, diabetes mellitus, obesity, smoking) and non-modifiable (age, sex, family history) RFs were recorded. Plaque number, plaque phenotype, and vulnerable features were analyzed.
resultsA total of 534 plaques from 131 patients (36.6% ACS) were analyzed. As the number of RFs increased, the number of plaques (P trend = 0.001) as well as plaques with a vulnerable phenotype (thin-cap fibroatheromas [TCFAs], P trend = 0.001) increased. An increasing number of RFs was also associated with a higher number of vulnerable features (P trend < 0.001), including more thin fibrous caps (P trend = 0.001), lipid-rich plaques (LRPs), macrophages, microvessels, and cholesterol crystals (all P trend ≤ 0.001). In multivariable analyses, only modifiable RF burden was associated with increased pan-coronary vulnerability (incidence rate ratio [IRR]: 1.36; 95% CI: 1.18-1.57; P < 0.001), including a higher prevalence of TCFAs (IRR: 1.48; 95% CI: 1.20-1.83; P < 0.001), LRPs (IRR: 1.35; 95% CI: 1.15-1.59; P < 0.001), and cholesterol crystals (IRR: 1.50; 95% CI: 1.21-1.87; P < 0.001).
conclusionsAs the number of cardiovascular RFs increased, the number of plaques, plaques with a high-risk phenotype, and vulnerable features also increased. Only increasing modifiable RF burden was associated with greater pan-coronary vulnerability, including more TCFAs and LRPs. CLINICAL
trial registrationClinicalTrials.gov NCT01110538.
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