The role of high-risk plaque in refining cardiovascular event prediction.

Purpose Of Review: High-risk plaque (HRP) features are commonly observed in patients with acute coronary syndromes (ACS); however, their individual predictive value remains limited. This review explores the importance of integrating anatomical and physiological assessments to enhance risk stratification and optimize therapeutic decision-making.

Recent Findings: Studies have indicated that combining HRP evaluation with hemodynamic assessment significantly improves prognostic accuracy, particularly in guiding revascularization strategies.

Using the Cerebrovascular Time Constant to Assess Cerebral Perfusion in Neonates.

This study aimed to investigate the relationship between the cerebrovascular time constant (Tau) and estimated cerebral perfusion pressure (CPPe) in neonates and clarify the normative reference data of Tau for different gestational ages.This multicenter, prospective study included infants with arterial lines who were admitted to neonatal intensive care units between December 2021 and May 2024. Tau and CPPe were calculated based on middle cerebral artery waveforms obtained using transcranial Doppler ultrasonography when clinicians collected arterial blood samples.

Improving the quality of care of respiratory syncytial virus in the neonatal and pediatric populations globally.

Respiratory syncytial virus (RSV) is the leading cause of hospitalization for bronchiolitis in infants worldwide, and age (<6 months) and underlying comorbidities (e.g., prematurity, congenital heart disease) are risk factors for severe disease.

Effect of Serum Carboxyl-Terminal Telopeptide of Type I Collagen on Clinical Outcomes in Patients With Coronary Artery Disease.

Background: Coronary artery disease (CAD) is a major cause of mortality worldwide. Serum carboxyl-terminal telopeptide of type I collagen (CITP), a marker of collagen degradation in the heart and blood vessels, is associated with plaque vulnerability and cardiac remodeling in patients with acute myocardial infarction. However, the effect of CITP on the clinical outcomes of patients with CAD has not yet been elucidated.

Nicotinamide Riboside Supplementation Benefits in Patients With Werner Syndrome: A Double-Blind Randomized Crossover Placebo-Controlled Trial.

Werner syndrome (WS) is a rare hereditary progeroid syndrome caused by mutations in the WRN gene. Patients frequently develop various age-associated diseases prematurely, often leading to early mortality (≤ 60 years of age). Depletion of nicotinamide adenine dinucleotide (NAD) has been reported in patients with WS, suggesting a key role in the pathogenesis of WS.

Coronary spotty calcification, compared with macro calcification, is associated with a higher level of vascular inflammation and plaque vulnerability in patients with stable angina.

Background And Aims: Spotty calcification in the coronary arteries is considered to represent plaque vulnerability, whereas more advanced calcification is thought to be a feature of advanced stable plaque. However, data supporting this notion is limited. Inflammation plays a key role in atherogenesis, including the formation of early-stage calcification.

High-risk plaque features and perivascular inflammation.

Background: The association between high-risk plaque (HRP) on coronary computed tomography angiography (CTA) and the level of perivascular inflammation has not been fully investigated.

Methods: Patients who underwent both CTA and optical coherence tomography (OCT) were included. The level of perivascular inflammation was assessed by pericoronary adipose tissue (PCAT) attenuation at two levels: lesion-specific and the proximal segment of the culprit vessel.

High-sensitivity C-reactive protein, plaque vulnerability and adverse events in patients with stable coronary disease: An optical coherence tomography study.

Background: Higher levels of high-sensitivity C-reactive protein (hsCRP) are associated with increased risk of cardiovascular events in patients with coronary artery disease (CAD).

Aims: To elucidate the characteristics of coronary plaques in patients with CAD with high hsCRP levels.

Methods: A total of 793 consecutive patients with stable CAD who underwent optical coherence tomography (OCT) of the culprit vessel during percutaneous coronary intervention were included.

Relationship Between Coronary Artery Calcium Score and Vulnerability of Culprit Plaque Assessed by OCT in Patients With Established Coronary Artery Disease.

Background: Coronary artery calcium score (CACS) is widely used for risk stratification. However, in patients with established coronary artery disease, its clinical implication and relationship with plaque vulnerability are unclear. We sought to correlate the CACS and plaque vulnerability assessed by optical coherence tomography.

Relationship between plaque burden and plaque vulnerability: Acute coronary syndromes versus chronic coronary syndrome.

Background: The relationship between plaque burden and microscopic characterization of plaque features as it pertains to clinical presentation has not been fully investigated. The aim of this study was to compare the relationship between plaque burden and plaque vulnerability in patients with acute coronary syndromes (ACS) versus chronic coronary syndrome (CCS).

Methods: Patients who underwent both coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) before coronary intervention were enrolled.

Relationship Between Calcified Plaque Burden, Vascular Inflammation, and Plaque Vulnerability in Patients With Coronary Atherosclerosis.

Background: Coronary artery calcification is an integral part of atherosclerosis. It has been suggested that early coronary artery calcification is associated with active inflammation, and advanced calcification forms as inflammation subsides. Inflammation is also an important factor in plaque vulnerability.

Computed Tomography Angiography Characteristics of Thin-Cap Fibroatheroma in Patients With Diabetes.

Background: It was recently reported that thin-cap fibroatheroma (TCFA) detected by optical coherence tomography was an independent predictor of future cardiac events in patients with diabetes. However, the clinical usefulness of this finding is limited by the invasive nature of optical coherence tomography. Computed tomography angiography (CTA) characteristics of TCFA have not been systematically studied.

Coronary plaque phenotype associated with positive remodeling.

Background: Positive remodeling is an integral part of the vascular adaptation process during the development of atherosclerosis, which can be detected by coronary computed tomography angiography (CTA).

Methods: A total of 426 patients who underwent both coronary CTA and optical coherence tomography (OCT) were included. Four machine learning (ML) models, gradient boosting machine (GBM), random forest (RF), deep learning (DL), and support vector machine (SVM), were employed to detect specific plaque features.

Layered plaque is associated with high levels of vascular inflammation and vulnerability in patients with stable angina pectoris.

Layered plaque, a signature of previous plaque destabilization and healing, is a known predictor for rapid plaque progression; however, the mechanism of which is unknown. The aim of the current study was to compare the level of vascular inflammation and plaque vulnerability in layered plaques to investigate possible mechanisms of rapid plaque progression. This is a retrospective, observational, single-center cohort study.

The prediction of estimated cerebral perfusion pressure with trans-systolic time in preterm and term infants.

It is important to monitor cerebral perfusion in infants because hypo- and hyperperfusion can contribute to neurological injury. This study aimed to clarify the relationship between trans-systolic time (TST) and critical closing pressure (CrCP) or estimated cerebral perfusion pressure (CPPe) in neonates. Moreover, we aimed to determine the TST values in preterm and term infants with stable cerebral perfusion to clarify normative reference data.

Sex-Specific Association Between Perivascular Inflammation and Plaque Vulnerability.

Background: It is not known whether there is a sex difference in the association between perivascular inflammation and plaque vulnerability. The aim of this study was to investigate the sex-specific association between perivascular inflammation and plaque vulnerability.

Methods: Patients who underwent coronary computed tomography angiography and optical coherence tomography were enrolled.

Proteomics associated with coronary high-risk plaques by optical coherence tomography.

Biomarkers are widely used for the diagnosis and monitoring of cardiovascular disease. However, markers for coronary high-risk plaques have not been identified. The aim of this study was to identify proteins specific to coronary high-risk plaques.

Body mass index and characteristics of coronary plaque in younger patients with type 2 diabetes.

Background And Aims: The association between the body mass index (BMI) and the characteristics of coronary plaque in younger type 2 diabetes (T2D) patients with coronary artery disease (CAD) remains to be elucidated.

Methods And Results: A total of 138 consecutive younger (<65 years) T2D patients with CAD, who underwent optical coherence tomography imaging of the culprit lesion were included. The patients were classified into either the higher BMI group (n = 68) or the lower BMI group (n = 70) according to the median of BMI (25.

Higher Noncalcified Plaque Volume Is Associated With Increased Plaque Vulnerability and Vascular Inflammation.

Background: Recently, it was reported that noncalcified plaque (NCP) volume was an independent predictor for cardiac events. Pericoronary adipose tissue (PCAT) attenuation is a marker of vascular inflammation and has been associated with increased cardiac mortality. The aim of this study was to evaluate the relationships between NCP volume, plaque vulnerability, and PCAT attenuation.

Protruding Aortic Plaque and Coronary Plaque Vulnerability.

Background: Protruding aortic plaque is known to be associated with an increased risk for future cardiac and cerebrovascular events. However, the relationship between protruding aortic plaque and coronary plaque characteristics has not been systematically investigated.

Methods And Results: A total of 615 patients who underwent computed tomography angiography, and preintervention optical coherence tomography imaging were included.

A novel deep learning model for a computed tomography diagnosis of coronary plaque erosion.

Patients with acute coronary syndromes caused by plaque erosion might be managed conservatively without stenting. Currently, the diagnosis of plaque erosion requires an invasive imaging procedure. We sought to develop a deep learning (DL) model that enables an accurate diagnosis of plaque erosion using coronary computed tomography angiography (CTA).