Matrix metalloproteinase-1 and interleukin-17A are associated with previous plaque disruption: a combined proteomics and optical coherence tomography study

Objectives Plaque disruption and subsequent healing are important contributors to coronary plaque progression; however, the biological mechanisms underlying this process remain incompletely understood. Optical coherence tomography (OCT) enables the identification of previously disrupted plaques, referred to as layered plaques. Proteomic analysis can characterize the molecular signature of layered plaques, providing insights into the biology of plaque disruption and healing. Furthermore, layered plaques indicate a more advanced stage of atherosclerotic disease, and their noninvasive identification could enhance patient risk stratification. This study aimed to identify plasma proteins associated with layered plaques at the culprit lesion in patients with stable angina pectoris (SAP). Methods Patients undergoing coronary angiography and OCT for SAP, with periprocedural blood sample collection, were enrolled. A proteomic analysis was subsequently performed, assessing 1470 proteins using the Olink explore 1536 reagent kit. Results Among 51 patients, OCT identified 31 (60.8%) patients with layered plaques at the culprit lesion. Patients with layered plaques exhibited 2.23- and 2.11-fold higher concentrations of interleukin-17A (IL17A) and matrix metalloproteinase-1 (MMP1), respectively ( P = 0.013 and P < 0.001), compared to those without layered plaques. Multivariable regression models demonstrated that IL17A and MMP1 were associated with layered plaques independent of known predictors (diameter stenosis > 70%, B2/C American College of Cardiology/American Heart Association lesion, and multivessel disease). Adding both proteins to the known predictors significantly improved the area under the curve (AUC) for layered plaque detection (AUC 0.831 vs. 0.581; P = 0.007). Conclusion In patients with SAP, IL17A, and MMP1 were independently associated with layered plaques identified by OCT.