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. 2025 Oct;18(5):1019-1031.
doi: 10.1007/s12265-025-10646-7. Epub 2025 Jun 20.

Identification of Plasma Lipidomic Signatures Associated with Coronary Plaque Vulnerability

Yanyan Gong  1   2   3 , Chen Zhao  4   5 , Lixin Jia  2   6 , Bokang Qiao  2   3 , Jinwei Tian  4   5 , Haichu Wen  2   3 , Yuan Wang  2   3 , Bo Yu  7   8 , Jie Du  9   10   11
Affiliations

Identification of Plasma Lipidomic Signatures Associated with Coronary Plaque Vulnerability

Yanyan Gong et al. J Cardiovasc Transl Res. 2025 Oct.

Abstract

The objective of this study was to identify plasma lipid signatures associated with plaque vulnerability. We retrospectively evaluated coronary plaque in 99 patients using optical coherence tomography (OCT) and quantified 489 plasma lipids. We identified intra- and inter-class crosstalk among ceramide (Cer)-phosphatidylinositol (PI)-esterified cholesterol (CE)-sphingomyelin (SM) (Cer-PI-CE-SM) in patients with thin-cap fibroatheroma (TCFA). CE-16:0, SM d18:1/16:1, and GM3 d18:1/22:0, emerged as potential markers of TCFA, correlating with the thinnest fibrous cap thickness and the presence of cholesterol crystallization. Compared to the clinical model (area under the curve [AUC] = 0.810), the AUC of the combined clinical-lipid model improved [AUC = 0.880, p = 0.032]. Calibration and decision curves demonstrated that the combined model exhibited superior diagnostic performance. We identified lipid molecules that are strongly correlated with plaque vulnerability, thus providing an option for the non-invasive identification of vulnerable plaques, which could potentially facilitate the tailored treatment for high-risk patients.

Keywords: Lipidomics; Optical coherence tomography; Sphingolipid metabolism; Thin-cap fibroatheroma (TCFA); Vulnerable plaque.

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Conflict of interest statement

Declarations. Ethical Approval: All procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975 as revised in 2000 (5). Informed consent was obtained from all patients included in the study. The study protocol was approved by the Human Ethics Review Committee of Harbi Medical University (China). No animal studies were carried out by the authors for this article. Clinical Trial Number: Not applicable. Conflicts of interest: There are no conflicts of interest.

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