Abstract 4722: Association of Systemic Markers of Inflammation and Thrombogenity to Coronary Plaque Composition Determined by Contrast Enhanced Dual Source Ct- Angiography
An elevated systemic inflammatory status is considered to be a riskfactor for future cardiovascular events. Multi Slice CT allows to assess and characterize coronary plaques and it is hypothesized that the presence of mixed and noncalcified plaques may be an indicator for plaque vulnerability. To date it is not clear whether there is an association between plaque composition determined by Dual Source CT and systemic biomarkers for inflammation and thrombogenity. In the present study we investigated 303 (102 female, 201 male, age 55 ± 9 years) consecutive patients with an intermediate likelihood for coronary artery disease, who underwent DSCT coronary angiography. The scan was performed on a Siemens Definiton Scanner (Forchheim, Germany) using a standard protocol. For analysis we divided the coronary tree in 15 segments according to the AHA-scheme and each segment was further divided in a proximal and a distal part. Each segment was then classified as containing no, noncalcified, mixed (20% calcium). The number of different plaques was correlated with the following biomarkers indicating the systemic inflammatory and thrombogenic status: IL-6, hsCRP, TNF-a, sCD40. In the univariate analysis we found a significant correlation between total plaque count hs-CRP and IL-6. Further there was a significant correlation between the number of mixed plaques and hsCRP and IL-6 but no correlation with noncalcified plaques. No correlation at all was observed between the ammount of any plaques and sCD40. In the mulivariate analysis and correction for traditional riskfactors the association between hsCRP and IL-6 between total plaque count and mixed plaques remained significant. Patients with hs-CRP and IL-6 levels in the highest tertile had on average significant more plaques than patients with biomarker levels in the 2nd and 1st tertile (9.3 ± 3 vs. 5.3 ± 2 vs. 2.1 ± 0.8, p< 0.02). This difference was mainly driven by differences among the number of mixed plaques (6.1 ± 2 vs. 3.2 ±1 vs. 0.6 ± 0.5, p< 0.03). Mixed plaques as determined by Dual Source CT are associated with systemic inflammation and thus be an indicator for atherosclerosis activity. We found no correlation between extent or composition of atherosclerosis with sCD40, a marker for the systemic thrombogenic status.