Correlation between lipidic content and arterial-wall plaque burden: A Lipid Rich Plaque study sub-analysis

Background: Large plaque burden (PB) has been linked to adverse coronary events. We sought to assess the correlation between lipidic content and arterial PB within the Lipid Rich Plaque (LRP) study.Methods: This analysis included 1269 patients and 5743 coronary segments with both evaluable Lipid Core Burden Index (maxLCBLI(4mm)) and PB. Non-culprit major adverse cardiac events (NC-MACE; defined as a composite of cardiac death, cardiac arrest, non-fatal myocardial infarction, acute coronary syndrome, revascularization, and hospital readmission for angina with progressive stenosis) were assessed by hazard ratios (HR) at 2 years.Results: NC-MACE for segment cohorts in the most vulnerable quadrant of maxLCBI(4mm) > 400 and PB >40% was the highest (HR, 3.78 [95% confidence interval (CI) 2.39-5.66]) with similar rates for just PB >40% (HR 1.31 [95% CI 0.81-2.02]) and just maxLCBLI(4mm) > 400 (HR 1.11 [95% CI 0.10-5.38]). Fewer events occurred in the maxLCBI(4mm) <= 400 and PB <= 40% quadrant (HR 0.25 [95% CI 0.11-0.50]).Conclusions: Coronary segments with high lipid content but no measurable PB were still associated with events at 2 years. NC-MACE vulnerability increased as the lipidic content and PB increased, with the highest incidence within segments having maxLCBI(4mm )> 400 and plaque >40%.