Cardiovascular Risk Factors Linked to Increased Plaque Burden

As number of risk factors increased, increase was seen in number of plaques and plaques with vulnerable phenotype
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TUESDAY, July 28, 2026 (HealthDay News) -- Cardiovascular risk factors (RFs) are associated with increased plaque burden, according to a study published online July 23 in JACC Advances.

Jakub Chmiel, M.D., from Harvard Medical School in Boston, and colleagues examined the association between RFs and pan-coronary plaque burden, plaque phenotype, and features of vulnerability. Modifiable and nonmodifiable RFs were recorded in patients undergoing three-vessel optical coherence tomography imaging.

The analysis included 534 plaques from 131 patients. The researchers found that the number of plaques and plaques with a vulnerable phenotype (thin-cap fibroatheromas [TCFAs]) increased as the number of RFs increased. In addition, a higher number of vulnerable features was seen in association with an increasing number of RFs, including more thin fibrous caps, lipid-rich plaques (LRPs), macrophages, microvessels, and cholesterol crystals. Only modifiable RF burden was associated with increased pan-coronary vulnerability in a multivariable analysis (incidence rate ratio, 1.36), including a higher prevalence of TCFAs, LRPs, and cholesterol crystals (incidence rate ratios, 1.48, 1.35, and 1.50, respectively).

"The higher the number of vulnerable, or rupture-prone plaques, the greater the chance that one of them will trigger an adverse event," senior author Ik-Kyung Jang, M.D., Ph.D., from Mass General Brigham Heart and Vascular Institute in Boston, said in a statement. "Our findings highlight the importance of early, intensive, and sustained interventions to control the modifiable risk factors and prevent future events."

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