Background
Methods
Patients and study design
Definitions of CAD risk factors
Blood tests
Coronary angiography and OCT analysis
Statistical analysis
Results
ROC analyses for the association between MPV and plaque rupture
Patient characteristics according to MPV levels
MPV<10.5 fL | MPV ≥10.5 fL) | t/χ2 | P | |
---|---|---|---|---|
Male | 33 (70.2) | 38 (80.9) | 1.439 | 0.230 |
Age (year) | 55.04 ± 13.13 | 56.60 ± 9.42 | 0.659 | 0.512 |
Hypertension | 19 (40.4) | 26 (55.3) | 2.089 | 0.148 |
Diabetes mellitus | 14 (29.8) | 23 (48.9) | 3.610 | 0.057 |
Smoking | 27 (57.4) | 30 (63.8) | 0.401 | 0.527 |
Drinking | 6 (12.8) | 12 (25.5) | 2.474 | 0.116 |
Family history of CAD | 6 (12.8) | 10 (21.3) | 1.205 | 0.272 |
Previous myocardial infarction | 8 (17.0) | 7 (14.9) | 0.079 | 0.778 |
Previous PCI | 7 (14.9) | 14 (29.8) | 3.005 | 0.083 |
BMI | 24.40 ± 3.2 | 25.92 ± 3.92 | 2.052 | 0.043 |
HDL-c (mmol/l) | 1.03 ± 0.25 | 0.92 ± 0.25 | 2.149 | 0.034 |
LDL-c (mmol/l) | 2.28 ± 0.8 | 2.63 ± 0.84 | 2.075 | 0.041 |
TC (mmol/l) | 3.63 ± 0.92 | 3.75 ± 1.1 | 0.560 | 0.577 |
TG (mmol/l) | 1.81 ± 0.93 | 1.8 ± 0.94 | 0.069 | 0.946 |
ApoA1 (g/L) | 1.14 ± 0.25 | 1.03 ± 0.28 | 2.118 | 0.037 |
ApoB (g/L) | 0.71 ± 0.17 | 0.86 ± 0.21 | 3.722 | < 0.001 |
Lp(a) (g/L) | 191 (100,292) | 205 (98,363) | 0.502 | 0.616 |
Creatinine (μmol/L) | 76.30 ± 18.66 | 80.72 ± 18.5 | 1.152 | 0.252 |
Carbamide (mmol/l) | 5.23 ± 1.58 | 5.58 ± 1.73 | 1.016 | 0.312 |
eGFR | 114.17 ± 36.99 | 101.1 ± 35.68 | 1.744 | 0.085 |
Uric acid (μmol/L) | 315.93 ± 103.6 | 348.14 ± 83.14 | 1.663 | 0.100 |
EF | 60.68 ± 8.05 | 59.71 ± 8.84 | 0.546 | 0.586 |
HbA1c (mmol/l) | 7.23 ± 1.34 | 7.24 ± 1.4 | 0.048 | 0.962 |
Clinical Diagnosis | 0.047 | 0.829 | ||
UAP | 31 (66.0) | 30 (63.8) | ||
NSTEMI | 16 (34.0) | 17 (36.2) | ||
Medications | ||||
Aspirin | 37 (78.7) | 32 (68.1) | 1.362 | 0.243 |
Statins | 11 (23.4) | 16 (34.0) | 1.299 | 0.254 |
β-Blockers | 16 (34.0) | 16 (34.0) | 0.000 | 1.000 |
ACEI/ARB | 14 (29.8) | 22 (46.8) | 2.881 | 0.090 |
CCB | 11 (23.4) | 11 (23.4) | 0.000 | 1.000 |
GRACE risk score | 102.07 ± 31.11 | 109.03 ± 21.24 | 1.001 | 0.321 |
CAG and OCT findings according to MPV levels
MPV<10.5 fL | MPV ≥10.5 fL | t/Z/χ2 | P | ||
---|---|---|---|---|---|
FCT (μm) | 0.11 (0.04,0.20) | 0.08 (0.04,0.12) | 1.642 | 0.101 | |
Lipid arc, degree | 100 (0,178) | 149 (0,229) | 1.192 | 0.233 | |
Rupture (%) | No | 45 (95.7) | 32 (68.1) | 12.136 | < 0.001 |
Yes | 2 (4.3) | 15 (31.9) | |||
Erosion (%) | No | 40 (85.1) | 35 (74.5) | 1.649 | 0.199 |
Yes | 7 (14.9) | 12 (25.5) | |||
Macrophage accumulation | 0 | 27 (57.4) | 15 (31.9) | 7.718 | 0.057 |
1 | 10 (21.3) | 18 (38.3) | |||
2 | 10 (21.3) | 12 (25.5) | |||
3 | 0 (0.0) | 1 (2.1) | |||
4 | 0 (0.0) | 1 (2.1) | |||
Vasa vasorum | No | 44 (93.6) | 43 (91.5) | 0.000 | 1.000 |
Yes | 3 (6.4) | 4 (8.5) | |||
Thrombus | No | 40 (85.1) | 26 (55.3) | 9.970 | 0.002 |
Yes | 7 (14.9) | 21 (44.7) | |||
Calcified nodule | No | 45 (95.7) | 44 (93.6) | 0.000 | 1.000 |
Yes | 2 (4.3) | 3 (6.4) | |||
Characteristic of plaque | Lipid | 31 (66.0) | 33 (70.2) | 2.196 | 0.333 |
Calcified | 4 (8.5) | 7 (14.9) | |||
Fibrotic | 12 (25.5) | 7 (14.9) | |||
TCFA | 45 (95.7) | 39 (83.0) | 2.798 | 0.094 | |
2 (4.3) | 8 (17.0) | ||||
NLA (mm2) | 10.40 ± 3.38 | 11.09 ± 3.20 | 0.932 | 0.354 | |
Diameter stenosis, % | 74.32 ± 15.81 | 75.72 ± 19.51 | 0.383 | 0.702 | |
Lesion length | 9.13 ± 3.48 | 9.97 ± 3.94 | 1.101 | 0.274 | |
Target vessel | LAD, n (%) | 35 (74.5) | 35 (74.5) | 0.750 | 0.687 |
LCX, n (%) | 5 (10.6) | 3 (6.4) | |||
RCA, n (%) | 7 (14.9) | 9 (19.1) | |||
Location of target plaque | Proximal | 34 (72.3) | 28 (59.6) | 2.310 | 0.276 |
Mid | 13 (27.7) | 18 (38.3) | |||
Distal | 0 (0.0) | 1 (2.1) | |||
Number of vascular lesions | 1 | 20 (42.6) | 25 (53.2) | 1.889 | 0.389 |
2 | 17 (36.2) | 11 (23.4) | |||
3 | 10 (21.3) | 11 (23.4) |
Coronary risk factors and laboratory data according to plaque vulnerability
Ruptured plaque | Nonrupture with TCFA | Nonrupture and non-TCFA | t/Z/χ2 | P | |
---|---|---|---|---|---|
Male | 16 (94.1) | 9 (90.0) | 46 (68.7) | 7.174 | 0.028 |
Age | 58.94 ± 10.23 | 50.10 ± 7.48 | 55.88 ± 11.93 | 1.938 | 0.150 |
Hypertension | 10 (58.8) | 3 (30.0) | 32 (47.8) | 2.142 | 0.343 |
Diabetes mellitus | 12 (70.6) | 7 (70.0) | 18 (26.9) | 15.23 | < 0.001 |
Current smoking | 10 (58.8) | 7 (70.0) | 40 (59.7) | 0.428 | 0.807 |
Current drinking | 4 (23.5) | 2 (20.0) | 12 (17.9) | 0.272 | 0.873 |
Family history of CAD | 2 (11.8) | 1 (10.0) | 13 (19.4) | 1.023 | 0.599 |
Previous myocardial infarction | 1 (5.9) | 2 (20.0) | 12 (17.9) | 1.926 | 0.382 |
Previous PCI | 7 (41.2) | 4 (40.0) | 10 (14.9) | 6.898 | 0.032 |
BMI | 28.38 ± 3.98 | 25.94 ± 1.92 | 24.23 ± 3.27 | 11.03 | < 0.001 |
LDL-c (mmol/l) | 2.53 ± 0.91 | 2.66 ± 0.78 | 2.41 ± 0.83 | 0.458 | 0.634 |
HDL-c (mmol/l) | 0.93 ± 0.32 | 0.98 ± 0.23 | 0.98 ± 0.24 | 0.252 | 0.777 |
ApoA1(g/L) | 1.03 ± 0.28 | 1.18 ± 0.34 | 1.09 ± 0.25 | 1.052 | 0.354 |
ApoB (g/L) | 0.84 ± 0.26 | 0.78 ± 0.18 | 0.77 ± 0.19 | 0.708 | 0.495 |
TC (mmol/l) | 3.61 ± 0.98 | 4.09 ± 0.79 | 3.65 ± 1.04 | 0.827 | 0.441 |
TG (mmol/l) | 2.08 ± 1.02 | 2.09 ± 0.91 | 1.70 ± 0.90 | 1.491 | 0.231 |
Lp(a) (g/L) | 219 (147,358) | 134 (75,302) | 191 (96,321) | 2.141 | 0.343 |
Uric Acid (μmol/L) | 348.79 ± 76.98 | 332.42 ± 59.12 | 327.72 ± 103.26 | 0.330 | 0.720 |
eGFR | 112.59 ± 47.06 | 105.06 ± 22.26 | 106.76 ± 35.91 | 0.195 | 0.823 |
WBC | 7.33 ± 1.46 | 7.54 ± 2.61 | 7.59 ± 2.62 | 0.076 | 0.927 |
PLT | 223.12 ± 51.27 | 256.3 ± 114.34 | 230.84 ± 61.11 | 0.822 | 0.443 |
MPV | 11.18 ± 0.69 | 11.04 ± 0.54 | 10.20 ± 1.00 | 10.017 | < 0.001 |
MPV ≥ 10.5 fL | 15 (88.2) | 8 (80.0) | 24 (35.8) | 18.929 | < 0.001 |
PCT (%) | 0.25 ± 0.06 | 0.28 ± 0.11 | 0.23 ± 0.06 | 2.117 | 0.126 |
PDW | 15.33 ± 1.2 | 15.14 ± 1.71 | 13.02 ± 2.35 | 10.536 | < 0.001 |
HCT (%) | 0.44 ± 0.05 | 0.44 ± 0.03 | 0.43 ± 0.04 | 0.253 | 0.777 |
RBC(10^12/L) | 4.77 ± 0.46 | 4.86 ± 0.4 | 4.77 ± 0.48 | 0.166 | 0.848 |
HGB (g/L) | 144.35 ± 16.82 | 146.5 ± 8.77 | 143.55 ± 16.21 | 0.157 | 0.855 |
EF | 59.51 ± 10.15 | 58.13 ± 12.70 | 60.69 ± 7.23 | 0.432 | 0.651 |
HbA1c | 7.47 ± 1.15 | 7.05 ± 1.10 | 7.20 ± 1.45 | 0.363 | 0.696 |
Clinical Diagnosis | 0.367 | 0.832 | |||
UAP | 12 (70.6) | 6 (60.0) | 43 (64.2) | ||
NSTEMI | 5 (29.4) | 4 (40.0) | 24 (35.8) | ||
Statins | 6 (35.3) | 4 (40.0) | 17 (25.4) | 1.303 | 0.521 |
Aspirin | 11 (64.7) | 7 (70.0) | 51 (76.1) | 0.937 | 0.626 |
β-Blockers | 7 (41.2) | 2 (20.0) | 23 (34.3) | 1.337 | 0.512 |
ARB/ACEI | 6 (35.3) | 2 (20.0) | 28 (41.8) | 1.965 | 0.374 |
CCB | 5 (29.4) | 2 (20.0) | 15 (22.4) | 0.431 | 0.806 |
Independent predictors of plaque vulnerability
Independent variables | Model 1 | Model 2 | ||||
---|---|---|---|---|---|---|
P | OR | 95%CI | P | OR | 95%CI | |
Diabetes mellitus | 0.043 | 5.242 | 1.056–26.015 | 0.032 | 6.492 | 1.176–35.849 |
BMI | 0.006 | 1.450 | 1.113–1.887 | 0.358 | 1.135 | 0.867–1.485 |
PDW | 0.012 | 1.999 | 1.166–3.425 | 0.046 | 1.672 | 1.010–2.768 |
Gender | 0.095 | 9.288 | 0.681–126.667 | 0.299 | 3.557 | 0.324–39.002 |
Previous PCI | 0.079 | 4.347 | 0.842–22.453 | 0.172 | 3.232 | 0.601–17.372 |
MPV ≥ 10.5 fL | 0.019 | 10.154 | 1.467–70.295 | 0.069 | 5.611 | 0.873–36.053 |
CAG and OCT findings according to the vulnerability of the coronary plaques
Group | Ruptured plaque | Nonrupture with TCFA | Nonrupture and non-TCFA | t/Z/χ2 | P | |
---|---|---|---|---|---|---|
Erosion (%) | No | 15 (88.2) | 5 (50.0) | 55 (82.1) | 5.465 | 0.065 |
Yes | 2 (11.8) | 5 (50.0) | 12 (17.9) | |||
Macrophage accumulation | 0 | 3 (17.6) | 2 (20.0) | 37 (55.2) | 19.328 | 0.005 |
1 | 7 (41.2) | 3 (30.0) | 18 (26.9) | |||
2 | 6 (35.3) | 4 (40.0) | 12 (17.9) | |||
3 | 0 (0.0) | 1 (10.0) | 0 (0.0) | |||
4 | 1 (5.9) | 0 (0.0) | 1 (1.5) | |||
Vasa vasorum | No | 16 (94.1) | 8 (80.0) | 63 (94.0) | 2.596 | 0.261 |
Yes | 1 (5.9) | 2 (20.0) | 4 (6.0) | |||
Thrombus | No | 4 (23.5) | 4 (40.0) | 58 (86.6) | 29.624 | < 0.001 |
Yes | 13 (76.5) | 6 (60.0) | 9 (13.4) | |||
NLA (mm2) | 13.52 ± 3.18 | 10.46 ± 2.59 | 10.16 ± 3.14 | 6.332 | 0.003 | |
Rate of stenosis | 81.12 ± 15.89 | 72.50 ± 16.54 | 73.85 ± 18.16 | 1.267 | 0.287 | |
Lesion length | 10.21 ± 4.65 | 9.40 ± 3.37 | 9.40 ± 3.55 | 0.325 | 0.723 | |
Calcified nodule | No | 17 (100.0) | 10 (100.0) | 62 (92.5) | 0.979 | 0.763 |
Yes | 0 (0.0) | 0 (0.0) | 5 (7.5) | |||
Target vessel | LAD | 10 (58.8) | 8 (80.0) | 52 (77.6) | 3.396 | 0.458 |
LCX | 2 (11.8) | 1 (10.0) | 5 (7.5) | |||
RCA | 5 (29.4) | 1 (10.0) | 10 (14.9) | |||
Location of target plaque | Pro | 10 (58.8) | 7 (70.0) | 45 (67.2) | 4.296 | 0.439 |
Mid | 6 (35.3) | 3 (30.0) | 22 (32.8) | |||
Distal | 1 (5.9) | 0 (0.0) | 0 (0.0) | |||
Number of vascular lesions | 1 | 9 (52.9) | 5 (50.0) | 31 (46.3) | 0.411 | 0.982 |
2 | 5 (29.4) | 3 (30.0) | 20 (29.9) | |||
3 | 3 (17.6) | 2 (20.0) | 16 (23.9) |