Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

Atherosclerosis. 2018 Jul;274:47-53. doi: 10.1016/j.atherosclerosis.2018.03.001. Epub 2018 Mar 2.

Abstract

Background and aims: Accumulation of advanced glycation end products (AGEs) can be measured non-invasively by skin autofluorescence (SAF) whose values are elevated in patients with cardiovascular disease (CVD). Optical coherence tomography (OCT) is an intravascular imaging modality that could allow visualization of plaque composition. We aim to examine the relationship between SAF and plaque composition evaluated by frequency-domain OCT in patients with CVD.

Methods: We prospectively enrolled 108 patients with CVD, who underwent OCT images during percutaneous coronary intervention (PCI). We divided the population into two groups: high SAF group (greater than or equal to 2.6) and low SAF one (less than 2.6). OCT findings were then compared between high and low SAF groups.

Results: The high SAF group showed much more thin cap fibroatheroma (TCFA), and calcified or ruptured plaques compared to the low SAF group. In multivariable analysis, low-density lipoprotein-cholesterol (LDL) (odds ratio: 1.15; 95% confidence interval: 1.00 to 1.32; p = 0.043), TG (OR for 10 mg/dl increase: 1.04; 95% confidence interval: 1.01 to 1.13; p = 0.016), and SAF (4.28; 1.86 to 9.84; p < 0.001) were independent correlates of TCFA, whereas SAF (2.61; 1.02 to 6.70; p = 0.047), estimated glomerular filtration rate (0.68; 0.49 to 0.93; p = 0.017) and LDL (1.19; 1.01 to 1.41; p = 0.037) were independent predictors of ruptured plaques. SAF and diabetes were independently associated with calcified plaques.

Conclusions: High SAF were associated with plaque vulnerability in patients with CVD, thus suggesting the clinical utility of SAF measurement in identifying high-risk patients for future cardiovascular events.

Keywords: Advanced glycation end products; Cardiovascular disease; Optical coherence tomography; Skin autofluorescence.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cholesterol, LDL / blood
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / metabolism
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / therapy
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / pathology
  • Female
  • Fibrosis
  • Glycation End Products, Advanced / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Necrosis
  • Percutaneous Coronary Intervention
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Prospective Studies
  • Registries
  • Risk Factors
  • Rupture, Spontaneous
  • Skin / metabolism*
  • Spectrometry, Fluorescence
  • Tomography, Optical Coherence*
  • Triglycerides / blood
  • Vascular Calcification / diagnostic imaging*
  • Vascular Calcification / metabolism
  • Vascular Calcification / pathology
  • Vascular Calcification / therapy

Substances

  • Biomarkers
  • Cholesterol, LDL
  • Glycation End Products, Advanced
  • Triglycerides