{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:52Z","timestamp":1791355972887,"version":"4.3.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with polyvascular disease (PolyVD) or atherosclerosis in the coronaries and at least 1 additional arterial bed are at increased risk of subsequent clinical cardiovascular events. While lowering low\u2010density lipoprotein cholesterol (LDL\u2010C) is recommended in the secondary prevention settings, whether PolyVD favorably responds to LDL\u2010C control remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The current study analyzed in 422 patients (422 target lesions) with coronary artery disease by using near\u2010infrared spectroscopy imaging before percutaneous coronary intervention in the REASSURE\u2010NIRS (Revelation of Pathophysiological Phenotypes of Vulnerable Lipid\u2010Rich Plaque on Near\u2010Infrared Spectroscopy; NCT04864171) multicenter registry. PolyVD was defined as concomitance of coronary artery disease and cerebrovascular disease or lower extremity arterial disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Maximum 4\u2010mm lipid\u2010core burden index, as a near\u2010infrared spectroscopy\u2013derived marker of plaque instability, and lipoprotein(a) [Lp(a)] were compared across LDL\u2010C levels (&lt;55, 55\u201369, and \u226570mg\/dL) in patients with (n=189) and without PolyVD (n=233). The proportion of LDL\u2010C &lt;55 mg\/dL was 15.3 and 9.4% in patients with and without PolyVD, respectively. In patients without PolyVD, LDL\u2010C &lt;55\u2009mg\/dL was associated with lower maximum 4\u2010mm lipid\u2010core burden index (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.045). Furthermore, a lower frequency of Lp(a) \u226550\u2009mg\/dL was observed in patients without PolyVD who achieved LDL\u2010C &lt;55\u2009mg\/dL (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.042). Only 4.5% of them presented with Lp(a) \u226550\u2009mg\/dL. However, achieved LDL\u2010C &lt;55\u2009mg\/dL was not associated with lower maximum 4\u2010mm lipid\u2010core burden index in patients with PolyVD (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.085). Moreover, Lp(a) remained comparable regardless of LDL\u2010C levels (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.902). Of note, 20.7% of patients with PolyVD with LDL\u2010C &lt;55\u2009mg\/dL exhibited Lp(a) \u226550\u2009mg\/dL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Coronary atheroma in patients with PolyVD was resistant to lowering LDL\u2010C &lt;55\u2009mg\/dL. Given that &gt;20% of those with LDL\u2010C &lt;55\u2009mg\/dL exhibited Lp(a) \u226550\u2009mg\/dL, Lp(a) may be a potential therapeutic target to delipidate coronary atheroma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048878","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:25:35Z","timestamp":1788150335000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lipidic Plaque Features of Polyvascular Disease in Response to Low\u2010Density Lipoprotein Cholesterol &lt;55\u2009mg\/dL: Implication of Circulating Lipoprotein(a) Levels"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0315-1395","authenticated-orcid":false,"given":"Aya","family":"Katasako\u2010Yabumoto","sequence":"first","affiliation":[{"name":"National Cerebral and Cardiovascular Center","place":["Suita, Osaka, Japan"]},{"name":"Graduate School of Medical 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