Lipidomics content analysis of atherosclerotic plaque after coronary artery bypass grafting

Objective To analyze the lipid composition of coronary endarterectomy (CE) plaques and explore the mechanisms affecting the mid- and long-term efficacy of CE. Methods Sixteen patients matched out of fifty patients with diffuse coronary artery disease performing coronary artery bypass grafting (CABG) with endarterectomy were enrolled from Beijing Anzhen Hospital between January 2024 and May 2024. Patients were divided into high-risk and low-risk groups to detect plaque tissue and CYP3A4 content, and analyze the restenosis rate by CATCH technique. Mendelian randomization consisting of univariate, mediation and sensitivity analysis were conducted to figure out the causal correlation. Results Lipidomics revealed significantly higher level of 4α-hydroxycholesterol (4αOH-CHO) in the high-risk group (0.050 μmol/g vs. 0.016 μmol/g, P < 0.05). Plasma CYP3A4 levels in the experimental group were higher immediate and in long term. A better long-term patency in the control group was discovered [stenosis rate (9.0 ± 1.9)% vs. (22.3 ± 2.3)%, P < 0.05)]. Genetical evidence showcased a causal relationship between hydroxycholesterol with atherosclerosis (AS) (P = 0.014), and increased CYP3A4 content may be due to the existing AS (P = 0.003). Conclusion High expression of 4αOH-CHO may accelerate AS and cause mid- and long-term restenosis after CE. In AS population, 4αOH-CHO may be identified as a practical marker of CYP3A4, assessing the progression mechanisms of AS after CE.