Abstract 13035: Levels of Inflammatory Biomarkers Correlate with Plaque Progression as Measured in Coronary CT Angiography
Background: Elevated levels of inflammatory biomarkers are associated with increased cardiovascular morbidity and mortality. We sought to determine whether blood biomarkers that predict clinical events also predict progression of coronary atherosclerotic plaque as detected by coronary CT angiography (CTA).
Methods: We included 62 patients (mean age 51 yr, 37% male) with acute chest pain from the ROMICAT trial who underwent CTA at baseline and after 24 ± 6 months. CT data sets was co-registered and assessed for presence of calcified and non-calcified plaques at intervals of 1 mm over the proximal 4 cm of each major coronary artery. In addition levels of high-sensitivity troponin-T (hsTnT), high sensitivity- CRP (hsCRP), Interleukine-18 (IL-18) and HDL were measured at the time of the baseline CT.
Results: A total of 8,271 cross sections were co-registered. At baseline, any plaque, calcified plaque (CAP) and non-calcified plaque (NCAP) were detected in 13.4%, 10.8%, and 2.6% of cross sections per patient. At follow-up, the prevalence of plaque increased significantly by 3.1 cross sections per patient (p < 0.01), On average 0.7 cross sections progressed from NCAP to CAP (p < 0.01), and new NCAP was detected in 2.0 cross sections (p < 0.01). After adjustment for age and gender, progression of any plaque correlated positively with hsCRP, Table 1. Progression of NCAP into CAP was linked to elevated levels of hsTnT and IL-18, Table 1. In univariate analysis, development of new NCAP correlated inversely with levels of HDL but attenuated after further adjustment, Table 1. In contrast, hsCRP remained correlated to the progression of any plaque (r = 0.31, p = 0.04) independent of traditional risk factors.
Conclusion: Elevated levels of inflammatory biomarkers are associated with progression of coronary artery plaques in patients presenting with acute chest pain. Levels of hsCRP independently predict plaque progression and may improve risk stratification in this group of patients.
- © 2011 by American Heart Association, Inc.