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medRxiv PreprintsInternational8 November 2026

Single-cell profiling of human plaques reveals cellular and molecular signatures of symptomatic atherosclerosis

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Atherosclerotic plaque vulnerability drives ischemic cardiovascular events, yet the cellular and molecular signatures distinguishing symptomatic from asymptomatic human plaques remain poorly defined. Here, we compared 53 symptomatic and asymptomatic human carotid plaques using single-nucleus (snRNA-seq; 17 samples, 19,100 nuclei; AtherOMICS biobank) and single-cell RNA sequencing (scRNA-seq; 36 samples, 68,983 cells; four public datasets), analyzed independently and combined by meta-analysis. Across sequencing approaches, symptomatic plaques showed cell-state shifts toward later or terminal st
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