Universität zu Köln

Burgmaier, Mathias, Milzi, Andrea ORCID: 0000-0001-7580-8029, Dettori, Rosalia, Burgmaier, Kathrin, Marx, Nikolaus and Reith, Sebastian (2018). Co-localization of plaque macrophages with calcification is associated with a more vulnerable plaque phenotype and a greater calcification burden in coronary target segments as determined by OCT. PLoS One, 13 (10). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Background The presence of plaque macrophages and microcalcifications are acknowledged features of plaque vulnerability. Experimental data suggest that microcalcifications promote inflammation and macrophages foster microcalcifications. However, co-localization of plaque macrophages and calcification (ColocCaMa) in coronary segments and its impact on plaque phenotype and lesion vulnerability is unexplored. Methods Plaque morphology including ColocCaMa of calcified coronary target segments in patients with stable coronary artery disease (n = 116) was analyzed using optical coherence tomography (OCT) prior to coronary intervention. Therefore we considered macrophages colocalized with calcification if their distance in an OCT frame was <100 mu m and OCT-defined microcalcifications with a calcium arc <22.5 degrees. Results ColocCaMa was present in 29/116(25.0%) coronary segments. Calcium burden was greater (calcium volume index:1731 +/- 1421 degrees*mm vs. 963 +/- 984 degrees*mm, p = 0.002) and calcifications were more superficial (minimal thickness of the fibrous cap overlying the calcification 35 +/- 37 mu m vs. 64 +/- 72 mu m, p = 0.005) in the presence of ColocCaMa. Segments with ColocCaMa demonstrated a higher incidence of newly suggested features of plaque vulnerability, with a 3.5-fold higher number of OCT-defined microcalcifications (0.7 +/- 1.0 vs. 0.2 +/- 0.6, p = 0.022) and a 6.7-fold higher incidence of plaque inflammation (macrophage volume index:148.7 +/- 248.3 degrees*mm vs. 22.2 +/- 57.4 degrees*mm, p<0.001). Clinically, intima-media thickness (IMT) in carotid arteries was increased in patients with ColocCaMa (1.02 +/- 0.30mm vs. 0.85 +/- 0.18, p = 0.021). In a multivariate model, IMT (OR1.76 for 100 mu m, 95%Cl 1.16-2.65, p = 0.007), HDL-cholesterol (OR0.36 for 10mg/d1, 95%CI 0.16-0.84, p = 0.017), calcium volume index (OR1.07 for 100 degrees *mm, 95%CI 1.00-1.14, p = 0.049), macrophage volume index (OR5.77 for 100 degrees*mm, 95%CI 12.04-16.3, p = 0.001) and minimal luminal area (OR3.41, 95%Cl 1.49-7.78, p = 0.004) were independent predictors of ColocCaMa. Conclusion Plaque macrophages co-localize with calcifications in coronary target segments and this is associated with high-risk morphological features including microcalcifications and macrophage infiltration as well as with greater calcification burden. Our data may add to the understanding of the relationship between plaque macrophages, vascular calcification and their clinical impact.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Burgmaier, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Milzi, Andrea UNSPECIFIED orcid.org/0000-0001-7580-8029 UNSPECIFIED Dettori, Rosalia UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-169018
DOI:	10.1371/journal.pone.0205984
Journal or Publication Title:	PLoS One
Volume:	13
Number:	10
Date:	2018
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPTICAL COHERENCE TOMOGRAPHY; SPOTTY CALCIFICATION; CAP RUPTURE; MICROCALCIFICATIONS; INFLAMMATION; HYPOTHESIS; MECHANISM; VESICLES; DISEASE Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16901