Abstract 499: Biomarkers of Atherosclerotic Disease Activity and Myocardial Remodeling: Correlation With Findings at Cardiac Computed Tomography
PURPOSE We aimed at correlating the plasma levels of circulating biomarkers of atherosclerotic disease activity and myocardial remodeling with findings at coronary CT angiography (cCTA).
METHODS 120 patients (54 women, 60 ±11 years) with suspected coronary artery disease underwent catheter angiography and dual-source cCTA. Patients were evaluated for the presence and severity of coronary artery stenosis and the degree of vessel involvement with atherosclerotic changes. Cardiac function parameters were obtained using cine CT reconstructions across the RR cycle. Plasma samples were collected from each patient and a cytokine and protease profiling panel was performed by multiplex analysis. The plasma concentrations of seven biomarkers with a reported relationship with atherosclerosis and myocardial remodeling were measured: TNFα, IL-6, IL-8, matrix metalloproteinase (MMP)-2, MMP-3, MMP-7, MMP-8. Data were analyzed by regression analysis.
RESULTS 89/120 patients showed atherosclerotic changes in at least one vessel based on cCTA. 58/120 had significant (>50%) stenosis in at least one coronary artery. We found a statistically significant (p<0.05) positive correlation between the plasma concentrations of IL-8 and MMP-3 and the degree of vessel involvement with atherosclerosis. MMP-7 levels were also significantly (p<0.05) higher in patients with 3 vessel disease (55.5±20.7ng vs 41.3±23.2ng). MMP2 and TNFα were significantly higher (p<0.05) in patients with significant stenosis (48.1±21.6ng vs 60.2±22.2ng and 25.2±10.7ng vs 37.6±13.4ng). Moreover, there was a significant (p<0.05) positive correlation between MMP7 and TNFα and cCTA measurements of cardiac function with better cardiac output in the presence of high plasma levels of those markers. MMP-8 and MMP-9 did not show any significant correlations.
CONCLUSION Our study suggests that elevated levels of IL-8, MMP-2, MMP-3, MMP-7 and TNFα are associated with CT evidence of greater atherosclerotic disease activity and obstructive disease. MMP7 and TNFα may also indicate more active myocardial remodeling with higher functional indices at CT. In a combined approach cCTA may be used to add specificity to general biomarker screening.