ArticleFrontiers in cardiovascular medicine2022
The effect of plaque morphology, material composition and microcalcifications on the risk of cap rupture: A structural analysis of vulnerable atherosclerotic plaques.
Article in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Cracking the Code of Calcification: How Presence and Burden among Intracranial Arteries Influence Stroke Incidence and Recurrence.AJNR. American journal of neuroradiology · 2025Pooled it
- A Hybrid Hierarchical Framework for Quantifying Mechanical Markers in Atherosclerotic Disease Progression: A New Approach for Diagnosis and Risk Assessment.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Screening for candidate genes and cell populations associated with atherosclerotic calcification using single-cell RNA sequencing.Mammalian genome : official journal of the International Mammalian Genome Society · 2026Article
- Coronary Calcified Nodules: From Pathological Definitions to Intravascular Imaging- and Morphology-Guided PCI.International journal of molecular sciences · 2026Review
- How plaque morphology and stenosis severity govern stent-artery interaction and deployment outcomes: a computational study.Medical & biological engineering & computing · 2026Article
- Spatial architecture of atherosclerotic plaques: coordinating immune responses through mechanotransduction and vesicular trafficking.Frontiers in cell and developmental biology · 2026Review
- Endothelial Surface Glycocalyx in Vascular Functions and Diseases.Advances in experimental medicine and biology · 2026Review
- AI-based modality-agnostic classification system for vascular calcifications.Scientific reports · 2025Article
- Modelling Atherosclerotic Plaque Cap Mechanics: Microcalcifications Reduce Mechanical Properties in Mesenchymal Stromal Cell-Based Model.Advanced biology · 2025Article
- Modulating vascular stresses through homeostatic remodelling: a multi-patient analysis of atherosclerotic carotid biomechanics.Journal of the Royal Society, Interface · 2025Article
- Current Advancements in the Diagnosis and Management of Mild-to-moderate Coronary Stenosis.Reviews in cardiovascular medicine · 2025Review
- An Open Multifunctional FPGA-Based Pulser/Receiver System for Intravascular Ultrasound (IVUS) Imaging and Therapy.Sensors (Basel, Switzerland) · 2025Article
- The Role of Lysyl Oxidase in the Pathological Stage of Atherosclerosis: Structural Stabilizer or Disease Driver?Current atherosclerosis reports · 2025Review
- Investigating the impact of microcalcification size and volume on collagenous matrix and tissue mechanics using a tissue-engineered atherosclerotic cap model.Frontiers in cardiovascular medicine · 2025Article
- The interplay of collagen, macrophages, and microcalcification in atherosclerotic plaque cap rupture mechanics.Basic research in cardiology · 2024Review
- Article
- Review
- A tissue-engineered model of the atherosclerotic plaque cap: Toward understanding the role of microcalcifications in plaque rupture.APL bioengineering · 2023Article
- Exosomes, microvesicles, and other extracellular vesicles-a Keystone Symposia report.Annals of the New York Academy of Sciences · 2023Article
- Size and proximity of micro-scale hard-inclusions increase the risk of rupture in fibroatheroma-like laboratory models.Journal of the mechanical behavior of biomedical materials · 2023Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The mechanical rupture of an atheroma cap may initiate a thrombus formation, followed by an acute coronary event and death. Several morphology and tissue composition factors have been identified to play a role on the mechanical stability of an atheroma, including cap thickness, lipid core stiffness, remodeling index, and blood pressure. More recently, the presence of microcalcifications (μCalcs) in the atheroma cap has been demonstrated, but their combined effect with other vulnerability factors has not been fully investigated. Materials and methods: We performed numerical simulations on 3D idealized lesions and a microCT-derived human coronary atheroma, to quantitatively analyze the atheroma cap rupture. From the predicted cap stresses, we defined a biomechanics-based vulnerability index (VI) to classify the impact of each risk factor on plaque stability, and developed a predictive model based on their synergistic effect. Results: Plaques with low remodeling index and soft lipid cores exhibit higher VI and can shift the location of maximal wall stresses. The VI exponentially rises as the cap becomes thinner, while the presence of a μCalc causes an additional 2.5-fold increase in vulnerability for a spherical inclusion. The human coronary atheroma model had a stable phenotype, but it was transformed into a vulnerable plaque after introducing a single spherical μCalc in its cap. Overall, cap thickness and μCalcs are the two most influential factors of mechanical rupture risk. Conclusions: Our findings provide supporting evidence that high risk lesions are non-obstructive plaques with softer (lipid-rich) cores and a thin cap with μCalcs. However, stable plaques may still rupture in the presence of μCalcs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.