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June 27, 2026Arteriosclerosis Thrombosis and Vascular Biology

Circulating sphingomyelins are linked to less vulnerable coronary plaque in MI, while 1-palmitoyl-2-oleoyl-GPE indicates more.

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Why the study?

Understanding mechanisms driving high-risk vulnerable plaque formation and progression to myocardial infarction is a key priority, motivating investigation into associations between circulating lipid metabolites and imaging-defined vulnerable plaque features.

Are specific circulating lipid metabolites associated with imaging-defined features of vulnerable coronary plaque in patients with myocardial infarction?

Population

877 patients with myocardial infarction following revascularization

Comparison

Levels of 424 plasma lipid metabolites vs imaging-defined coronary plaque measures

Design

Substudy with external cohort validation

Key result

Circulating sphingomyelins were negatively associated, and 1-palmitoyl-2-oleoyl-GPE positively associated, with vulnerable coronary plaque features in patients with myocardial infarction (q<0.05).

Authors

TSTania SharmaTFTove FallSSSergi Sayols-Baixeras

Discussion

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Overview

These metabolite-plaque associations require prospective validation; extends metabolomics to vulnerable features post-MI.

Key Points

  • The study aims to understand the relationship between lipid metabolites and features of vulnerable coronary plaques in patients after myocardial infarction.
  • Patients post-myocardial infarction underwent coronary artery imaging.
  • Lipid metabolites in plasma were quantified using mass spectrometry.
  • Multivariable models evaluated associations with plaque metrics in 877 patients.
  • Sphingomyelins showed an inverse association with plaque metrics, indicating potential protective properties.
  • 1-palmitoyl-2-oleoyl-GPE (16:0/18:1) was positively associated with plaque metrics, suggesting it may contribute to vulnerability.
  • 27 lipid species across 7 pathways remained significant after correction for multiple testing.

Study Design

Type

Observational (n=877)

Multicenter

Yes

Structured PICO

Are specific circulating lipid metabolites associated with imaging-defined features of vulnerable coronary plaque in patients with myocardial infarction?

P
Population
877 patients with myocardial infarction following revascularization who underwent 3-vessel coronary artery imaging to assess nonflow-limiting plaques.
E
Exposure
Circulating lipidomics profiling (424 lipid metabolites in plasma quantified by mass spectrometry)
O
Outcome
Associations with pan-coronary lipid, pan-coronary plaque burden, and high-risk vulnerable plaque measures (maximum lipid core burden index within any 4-mm segment ≥324.7 and plaque burden ≥70%)surrogate

Main Result

p-value: p=q<0.05

Specific circulating lipid metabolites, notably sphingomyelins (inversely) and 1-palmitoyl-2-oleoyl-GPE (positively), are associated with vulnerable coronary plaque features, providing potential novel targets for diagnostics and therapeutics.

Cite This Study

Sharma et al. (2026) conducted an observational in Myocardial infarction (n=877). Circulating lipid metabolites was evaluated on Pan-coronary lipid, pan-coronary plaque burden, and high-risk vulnerable plaque measures (p=q<0.05). Circulating sphingomyelins were negatively associated, and 1-palmitoyl-2-oleoyl-GPE positively associated, with vulnerable coronary plaque features in patients with myocardial infarction (q<0.05).

synapsesocial.com/papers/6a3f67e2aea7db3c1953f2bbhttps://doi.org/10.1161/atvbaha.125.324430
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Global lipidomic landscape of vulnerable carotid artery plaques: A preliminary analysis demonstrating proinflammatory features, apoptosis, and structural remodeling2026
  2. 2Machine learning-driven lipidomics for non-invasive assessment of coronary lesion grading2025
  3. 3Circulating protein biomarkers and their association with vulnerable plaque characteristics – a PROSPECT II substudy2025 · 2 citations
  4. 4Predictors of Coronary Plaque Vulnerability in Patients with Stable Coronary Artery Disease2020 · 2 citations
  5. 5Plasma lipidomics and coronary plaque changes: a substudy of the SMARTool clinical trial2024 · 1 citations