A novel monocyte-based biomarker associated with pan-vascular atherosclerotic plaques: a multicenter cross-sectional study

Background and purpose: Atherosclerotic diseases are a leading cause of death worldwide, highlighting an urgent need for the early detection of pan-vascular atherosclerotic plaques in asymptomatic individuals. This study aimed to investigate the association between a novel biomarker, the pan-vascular atherosclerosis risk score (PARS, the ratio of spleen tyrosine kinase [SYK]-positive classical monocytes to total classical monocytes) and the presence of pan-vascular plaques. Methods: In this multicenter cross-sectional study, we enrolled 513 asymptomatic participants aged 40 to 65 years from three hospitals in China. PARS was measured using flow cytometry. All participants underwent coronary computed tomography angiography, carotid, and femoral artery ultrasound to assess atherosclerotic plaques systematically. The association between PARS and plaque prevalence was assessed using multivariable logistic regression, and its discriminatory ability was evaluated with receiver operating characteristic curve analysis. Results: Pan-vascular plaques were identified in 361 (70.37%) participants. After adjusting for confounders, each 1% increase in PARS was associated with 41% higher odds of having pan-vascular plaques (odds ratio: 1.41, 95% confidence interval: 1.31–1.51). The discriminatory ability of PARS was strong, with an area under the receiver operating characteristic curve of 0.84. The optimal PARS cutoff value was 9.91%, providing a sensitivity of 78.90% and specificity of 77.60%. The sensitivity of PARS increased significantly with the number of vessel types involved: 73.18% for one vessel, 80.20% for two vessels, and 90.12% for three vessels (P for trend < 0.01). Conclusion: PARS is independently associated with pan-vascular atherosclerotic plaques in asymptomatic middle-aged adults, demonstrating good discriminatory accuracy.