The impact of serum trans fatty acids concentration on plaque vulnerability in patients with coronary artery disease: Assessment via optical coherence tomography

Yoshinori Nagasawa, Toshiro Shinke, Ryuji Toh, Tatsuro Ishida, Hiromasa Otake, Tomofumi Takaya, Daisuke Sugiyama, Takayosi Toba, Masaru Kuroda, Hachidai Takahashi, Daisuke Terashita, Natsuko Tahara, Yuto Shinkura, Kenzo Uzu, Daiji Kashiwagi, Koji Kuroda, Yuichiro Nagano, Hiroyuki Yamamoto, Kenichi Yanaka, Yoshiro TsukiyamaKen ichi Hirata

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Abstract

Background and aims Recent epidemiological studies have showed that excessive intake of trans fatty acids (TFA) can be a residual risk for the development of coronary artery disease (CAD) even under medical management, including statins. This study aimed at investigating the association between lipid profile, including serum TFA concentration, and plaque vulnerability using optical coherence tomography (OCT). Methods The level of serum elaidic acid, a major TFA component, was measured using gas chromatography in 161 consecutively enrolled patients with CAD under guideline-directed risk factor management. OCT was performed to evaluate morphological features of angiographic intermediate stenosis (30% < diameter of stenosis <70%). OCT data were also used to measure lipid index (LI), defined as mean lipid arc multiplied by lipid length, and determine the presence of thin-cap fibroatheroma (TCFA), defined as a lipid-rich plaque with the smallest fibrous cap thickness <65 μm and the maximal arc >90°. Results Among 190 lesions assessed using OCT, 49 TCFAs were detected. In patients with at least one TCFA lesion, levels of elaidic acid (12.9 ± 4.9 vs. 10.3 ± 4.3 μmol/L, p = 0.001), triglycerides (169 ± 81 vs. 130 ± 60 mg/dL, p = 0.005), and remnant-like particle cholesterol (10.4 ± 6.5 vs. 7.7 ± 4.7 mg/dL, p = 0.005) were higher than in those without TCFAs. Generalized estimating equations identified elaidic acid level as the independent risk factor of TCFA. LI had a positive correlation with elaidic acid level (r = 0.173, p = 0.025). Conclusions TFA may affect plaque vulnerability in patients with CAD. Serum TFA concentration may represent another cardiovascular risk factor during conventional risk factor management.

Original languageEnglish
Pages (from-to)312-317
Number of pages6
JournalAtherosclerosis
Volume265
DOIs
Publication statusPublished - 2017 Oct 1

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Keywords

  • Optical coherence tomography
  • Thin-cap fibroatheroma
  • Trans fatty acid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nagasawa, Y., Shinke, T., Toh, R., Ishida, T., Otake, H., Takaya, T., Sugiyama, D., Toba, T., Kuroda, M., Takahashi, H., Terashita, D., Tahara, N., Shinkura, Y., Uzu, K., Kashiwagi, D., Kuroda, K., Nagano, Y., Yamamoto, H., Yanaka, K., ... Hirata, K. I. (2017). The impact of serum trans fatty acids concentration on plaque vulnerability in patients with coronary artery disease: Assessment via optical coherence tomography. Atherosclerosis, 265, 312-317. https://doi.org/10.1016/j.atherosclerosis.2017.06.922