Coronary artery disease (CAD) is a pathological condition resulting from the progressive development of lipid-rich atherosclerotic plaques within the coronary artery walls, extending into the vessel lumen. This process involves chronic inflammation and gradual arterial narrowing, which can significantly impair blood flow and lead to severe clinical complications. Besides, plaque progressive growth may weaken the vessel wall, compromising its structural integrity. Given these threats, developing an effective risk prediction tool could facilitate early identification of high-risk cases, enabling preventing interventions and reducing the burden on the healthcare system. Intravascular optical coherence tomography (IVOCT) is an advanced imaging technique that has enhanced atherosclerotic lesion detection and assessment due to its exceptional resolution (10-20 μm).