{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:07:09Z","timestamp":1784012829056,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Vulnerable plaque rupture is a major mechanism underlying acute coronary events, but imaging\u2010based risk assessment using individual plaque features remains limited. The histology\u2010derived vulnerability index (VI) integrates multiple plaque components and is associated with adverse cardiovascular outcomes but requires ex vivo assessment. Optical coherence tomography (OCT) enables high\u2010resolution in vivo plaque characterization, and the OCT\u2010derived index of plaque attenuation (IPA) may provide a quantitative measure of integrated plaque vulnerability.<\/jats:p>\n \n AIMS:<\/jats:bold>\n This study aimed to determine the association between OCT\u2010derived IPA and histological VI and to identify the histological plaque components contributing to IPA.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In 240 coronary blocks from 10 human cadaveric hearts, co\u2010registered OCT and histology were performed. IPA was calculated from attenuation images. Histology quantified necrotic core, collagen, \u03b1\u2010SMA\n +<\/jats:sup>\n area, and macrophages (CD68\n +<\/jats:sup>\n , CD206\n +<\/jats:sup>\n ). Associations were assessed using correlation and multivariable regression.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n IPA at a 9\u2009mm\n \u22121<\/jats:sup>\n threshold (IPA\n 9<\/jats:sub>\n ) correlated with VI (\n r<\/jats:italic>\n \u2009=\u20090.714,\n p<\/jats:italic>\n \u2009<\u20090.001) and discriminated high\u2010VI blocks (AUC\u2009=\u20090.852). CD68\n +<\/jats:sup>\n macrophage area (\n \u03b2<\/jats:italic>\n \u2009=\u200917.20,\n p<\/jats:italic>\n \u2009<\u20090.001) and necrotic core (\n \u03b2<\/jats:italic>\n \u2009=\u20091.39,\n p<\/jats:italic>\n \u2009=\u20090.013) predicted higher IPA, whereas collagen and \u03b1\u2010SMA\n +<\/jats:sup>\n area were inversely associated. CD206\n +<\/jats:sup>\n areas were not independently related with IPA, but the CD206\n +<\/jats:sup>\n \/CD68\n +<\/jats:sup>\n ratio significantly improved IPA model performance (\u0394\n R<\/jats:italic>\n 2<\/jats:sup>\n = 0.023,\n p<\/jats:italic>\n \u2009=\u20090.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n OCT\u2010derived IPA closely corresponds to histological VI and is primarily driven by necrotic core and pro\u2010inflammatory macrophage infiltration. IPA may serve as a clinically obtainable quantitative OCT marker for integrated assessment of inflammation\u2010weighted plaque vulnerability.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ccd.70742","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:39:55Z","timestamp":1784011195000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["OCT\u2010Derived Index of Plaque Attenuation as a Quantitative Metric for Histological Plaque Vulnerability in Human Coronary Atherosclerosis"],"prefix":"10.1002","author":[{"given":"Yang","family":"Cheng","sequence":"first","affiliation":[{"name":"The Second School of Clinical Medicine Southern Medical University Guangzhou China"},{"name":"Department of Cardiology The Six Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Six Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Six Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingxuan","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Six Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Six Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Basic Medical Science Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simeng","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Medicine Nankai University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Basic Medical Science Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4409-9375","authenticated-orcid":false,"given":"Yundai","family":"Chen","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine Southern Medical University Guangzhou China"},{"name":"Department of Cardiology The Six Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"2320","DOI":"10.1016\/S0735-1097(24)04310-9","article-title":"Global Prevalence of Coronary Artery Disease: An Update From the Global Burden of Disease Study","volume":"83","author":"Stark B.","year":"2024","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1161\/CIRCRESAHA.118.311098","article-title":"Reassessing the Mechanisms of Acute Coronary Syndromes","volume":"124","author":"Libby P.","year":"2019","journal-title":"Circulation Research"},{"key":"e_1_2_12_4_1","first-page":"709","article-title":"Vulnerable or High\u2010Risk Plaque","volume":"18","author":"Vergallo R.","year":"2025","journal-title":"JACC: Cardiovascular Imaging"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1038\/nrcardio.2014.62","article-title":"Clinical Classification of Plaque Morphology in Coronary Disease","volume":"11","author":"Otsuka F.","year":"2014","journal-title":"Nature Reviews Cardiology"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1016\/S0140-6736(19)31794-5","article-title":"Identification of Patients and Plaques Vulnerable to Future Coronary Events With Near\u2010Infrared Spectroscopy Intravascular Ultrasound Imaging: A Prospective, Cohort Study","volume":"394","author":"Waksman R.","year":"2019","journal-title":"Lancet"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1056\/NEJMoa1002358","article-title":"A Prospective Natural\u2010History Study of Coronary Atherosclerosis","volume":"364","author":"Stone G. 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