Lipoprotein(a)-associated thrombus formation and plaque healing in acute coronary syndromes: insights from optical coherence tomography.

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2026-04-03 DOI:10.1097/MCA.0000000000001637

Yusaku Shibata, Osamu Kurihara, Nobuaki Kobayashi, Fumitaka Okajima, Masamichi Takano, Kuniya Asai

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引用次数: 0

Abstract

Background: Elevated lipoprotein(a) levels are associated with myocardial infarction; however, in-vivo evidence linking lipoprotein(a) to intracoronary thrombosis remains limited. We evaluated phase-specific lipoprotein(a) levels during the hyperacute, acute, and stable phases of acute coronary syndrome and their associations with angiographic and optical coherence tomography findings.

Methods: We analyzed 142 patients with acute coronary syndrome who underwent optical coherence tomography during percutaneous coronary intervention and for whom lipoprotein(a) was measured in the hyperacute (n = 58), acute (n = 125), or stable (n = 51) phases.

Results: Baseline demographics, laboratory data, angiographic findings, and optical coherence tomography characteristics were similar across phases. Patients with intracoronary thrombus had significantly higher hyperacute-phase lipoprotein(a) levels than did those without [10.2 (interquartile range: 5.4-18.8) vs. 3.7 (3.0-10.3) mg/dl; P = 0.033]. In addition, a greater increase in lipoprotein(a) from the hyperacute to the acute phase was associated with thrombus presence [12.1 (4.0-18.4) vs. 2.35 (0.0-7.1) mg/dl; P = 0.027]. Conversely, patients with layered plaque on acute-phase optical coherence tomography demonstrated significantly lower stable-phase lipoprotein(a) levels than did those without [4.1 (3.0-7.1) vs. 13.0 (5.7-21.3) mg/dl; P = 0.014]. No significant associations were observed for acute-phase lipoprotein(a) levels.

Conclusion: Elevated hyperacute-phase lipoprotein(a) levels were associated with intracoronary thrombus, whereas low stable-phase lipoprotein(a) levels were associated with layered plaque. These phase-specific relationships suggest that lipoprotein(a) influences thrombosis and plaque healing in acute coronary syndrome, and that stable-phase lipoprotein(a) levels may better reflect baseline biology and help identify prior subocclusive events.

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急性冠状动脉综合征中脂蛋白(a)相关血栓形成和斑块愈合：来自光学相干断层扫描的见解

背景：脂蛋白(a)水平升高与心肌梗死有关；然而，将脂蛋白(a)与冠状动脉内血栓形成联系起来的体内证据仍然有限。我们评估了急性冠状动脉综合征超急性期、急性期和稳定期的阶段特异性脂蛋白(a)水平及其与血管造影和光学相干断层扫描结果的关系。方法：我们分析了142例急性冠状动脉综合征患者，他们在经皮冠状动脉介入治疗期间接受了光学相干断层扫描，并在超急性期（n = 58）、急性期（n = 125）和稳定期（n = 51）测量了脂蛋白(a)。结果：基线人口统计学、实验室数据、血管造影结果和光学相干断层扫描特征在各个阶段相似。冠状动脉内血栓患者的超急性期脂蛋白(a)水平明显高于无血栓患者[10.2（四分位数范围：5.4-18.8）vs 3.7 (3.0-10.3) mg/dl；p = 0.033]。此外，从超急性期到急性期脂蛋白(a)的较大增加与血栓存在相关[12.1 (4.0-18.4)vs. 2.35 (0.0-7.1) mg/dl；p = 0.027]。相反，急性期光学相干断层扫描显示，有层状斑块的患者的稳定期脂蛋白(a)水平明显低于没有斑块的患者[4.1 (3.0-7.1)vs 13.0 (5.7-21.3) mg/dl；p = 0.014]。急性期脂蛋白(a)水平无显著相关性。结论：超急性期脂蛋白(a)水平升高与冠状动脉内血栓有关，而低稳定期脂蛋白(a)水平与层状斑块有关。这些阶段特异性关系表明，脂蛋白(a)影响急性冠状动脉综合征的血栓形成和斑块愈合，而稳定阶段脂蛋白(a)水平可能更好地反映基线生物学，并有助于识别先前的亚封闭事件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.