@article{Sharma:2026:10.1161/ATVBAHA.125.324430,
author = {Sharma, T and Fall, T and Sayols-Baixeras, S and Maehara, A and Maeng, M and Kjøller-Hansen, L and Engstrøm, T and Ben-Yehuda, O and Matsumura, M and Fröbert, O and Persson, J and Wiseth, R and Larsen, AI and Smith, JG and Engström, G and Ärnlöv, J and Borén, J and Khamis, R and Tsimikas, S and Koul, S and Rylance, R and Ali, ZA and James, SK and Stone, GW and Erlinge, D},
doi = {10.1161/ATVBAHA.125.324430},
journal = {Arterioscler Thromb Vasc Biol},
title = {Linking Lipidomics to Vulnerable Coronary Plaques: A PROSPECT II Substudy.},
url = {http://dx.doi.org/10.1161/ATVBAHA.125.324430},
year = {2026}
}

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TY  - JOUR
AB  - BACKGROUND: Lipidomics, the comprehensive profiling of circulating lipid species, has emerged as a powerful tool to investigate metabolic alterations underlying coronary atherosclerosis. Understanding the mechanisms driving high-risk vulnerable plaque formation and progression to myocardial infarction remains a key therapeutic priority. This study investigates associations between circulating lipid metabolites and imaging-defined features of vulnerable coronary plaque. METHODS: Following revascularization, patients with myocardial infarction underwent 3-vessel coronary artery imaging with near-infrared spectroscopy and intravascular ultrasound to assess nonflow-limiting plaques for lipid core burden index and plaque burden. Multivariable models evaluated associations between 424 lipid metabolites in plasma, quantified by mass spectrometry, pan-coronary lipid, pan-coronary plaque burden, and high-risk vulnerable plaque measures (maximum lipid core burden index within any 4-mm segment across the entire lesion ≥324.7 and plaque burden ≥70%) in 877 patients. Findings were validated in the SCAPIS study (Swedish Cardiopulmonary Bioimage Study) using coronary computed tomography angiography-based measures of coronary artery calcium score and segment involvement score. RESULTS: We identified 156 significant associations (P<0.05) between lipid metabolites and coronary plaque characteristics across 39 metabolic pathways. Sphingomyelins were inversely associated with all plaque metrics, and 1-palmitoyl-2-oleoyl-GPE (16:0/18:1), a phosphatidylethanolamine, was positively associated with all plaque metrics. After correcting for multiple testing, 27 lipid species across 7 pathways remained significant (q<0.05). The majority were linked to pan-coronary lipid burden, with the strongest inverse association observed for sphingomyelin d18:1/22:1, d18:2/22:0, and d16:1/24:1. Similar inverse patterns were seen for select dihydrosphingomyelins and fatty acid dicarboxylates. I
AU  - Sharma,T
AU  - Fall,T
AU  - Sayols-Baixeras,S
AU  - Maehara,A
AU  - Maeng,M
AU  - Kjøller-Hansen,L
AU  - Engstrøm,T
AU  - Ben-Yehuda,O
AU  - Matsumura,M
AU  - Fröbert,O
AU  - Persson,J
AU  - Wiseth,R
AU  - Larsen,AI
AU  - Smith,JG
AU  - Engström,G
AU  - Ärnlöv,J
AU  - Borén,J
AU  - Khamis,R
AU  - Tsimikas,S
AU  - Koul,S
AU  - Rylance,R
AU  - Ali,ZA
AU  - James,SK
AU  - Stone,GW
AU  - Erlinge,D
DO  - 10.1161/ATVBAHA.125.324430
PY  - 2026///
TI  - Linking Lipidomics to Vulnerable Coronary Plaques: A PROSPECT II Substudy.
T2  - Arterioscler Thromb Vasc Biol
UR  - http://dx.doi.org/10.1161/ATVBAHA.125.324430
UR  - https://www.ncbi.nlm.nih.gov/pubmed/42345096
ER  - 

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