Abstract Th0050: Study on the predictive value of plasma ceramide measurement in coronary plaque progression

It is acknowledged that lipid is crucial risk factor in the atherosclerotic progression. However, traditional lipid markers, such as low-density lipoprotein cholesterol, are insufficient to comprehensively reflect the stability of coronary plaques. Ceramide, a bioactive lipid molecule that has garnered considerable attention in recent years, plays a crucial role in the formation of atherosclerotic plaques and the prediction of cardiovascular events. Studies have shown that ceramide is involved in various pathophysiological processes, including apoptosis, inflammatory responses, and lipid metabolism disorders, and is closely associated with the stability of coronary atherosclerotic plaques. Clinical studies have indicated that distinct plasma ceramide ratios emerge as significant predictors of cardiovascular mortality in both patients with stable coronary artery disease and acute coronary syndromes, offering prognostic value above currently used lipid markers. However,the value of ceramide in predicting plaque progression warrants further exploration. Optical coherence tomography (OCT) is acknowledged as a useful technology to precisely assess characteristics of coronary plaques such as morphology, fibrous cap thickness, and lipid core size, providing important radiological evidence to determine plaque stability and progression. However, radiological assessment alone cannot reveal the biological activity of plaques. Therefore, combining OCT with biomarkers when predicting the plaque progression holds significant research value. This clinical study is a multicentric prospective cohort study, called OCT-CARE, and it is registered on clinicaltrail (NoChiCTR2300069716). This study plans to enroll 330 acute coronary syndrome patients, completing OCT examinations and ceramide measurements at baseline. Patients will be followed up for one year, and after one year, OCT examinations and plasma ceramide concentration measurements will be repeated. The study will observe changes in plasma ceramide ratios and the Ceramide Enrichment Ratio Test(CERT) scores and the changes of coronary plaque microstructure were observed based on OCT.We hope to explore the value of ceramide in assessing the progression of coronary plaques, with the aid of Optical Coherence Tomography (OCT) technology through the study.