Abstract 10886: Serum Levels of Immunoglobulin G4 are Associated With Non-Calcified Coronary Plaque but Not With Calcified Plaque
Objective: Immunoglobulin G4 (IgG4)-related disease may involve various organs including the cardiovascular system. By contrast, it remains unclear whether IgG4-related immuno-inflammation is associated with coronary stenosis. We analyzed the association of serum IgG4 levels with calcified and non-calcified coronary plaques.
Methods: Serum IgG4 levels were measured in 287 patients (154 males; mean age, 67.8 ± 10.8 years) without previous coronary interventions who underwent 320-slice coronary computed tomography angiography (CCTA). The vulnerable coronary plaques were evaluated for the CT plaque characteristics, including low-density plaque (LDP: <39 HU), positive remodeling (PR), and spotty calcification (SC).
Results: A total of 133 patients (46.3%) were judged to have coronary artery disease (CAD) by CCTA. The median of serum IgG4 levels was significantly higher in patients with CAD than in those without (32.1 mg/dL vs. 23.9 mg/dL, P=0.019). In patients with non-calcified plaque (NCP), serum levels of IgG4 were significantly increased than in those without (32.0 mg/dL vs. 22.5 mg/dL, P=0.029). On the other hand, serum IgG4 levels did not differ according to the presence or absence of calcified plaque (CP) (30.3 mg/dL vs. 27.8 mg/dL, P=0.415). Serum levels of IgG4 were significantly elevated in patients with LDP (33.0 mg/dL vs. 24.9 mg/dL, P=0.003) and PR (31.6 mg/dL vs. 25.7 mg/dL, P=0.014) than in those without. Patients with SC had slightly, but not significantly, higher serum IgG4 levels than those without (31.4 mg/dL vs. 23.7 mg/dL, P=0.069). Age- and gender-adjusted logistic regression analysis showed that the fourth quartile of IgG4 (≥54.3 mg/dL) was significantly associated with LDP with an odds ratio of 2.18 (95% CI 1.04-4.54), compared with the lowest quartile.
Conclusions: Serum IgG4 levels were significantly associated with NCP, especially with LDP, but not with CP. IgG4-related immuno-inflammation may play a role in plaque vulnerability.
- © 2013 by American Heart Association, Inc.