Abstract 12442: Hs-CRP Level Represents the Disease Burden and the Age but Not Vulnerability of Coronary Atherosclerosis: A Study of Volumetric Plaque Composition by 3-vessel Virtual Histology-intravascular Ultrasound
Background: hs-CRP has been known as a systemic inflammatory marker of atherosclerosis and considered as one of the predictors of future cardiac events. Some reports presented hs-CRP level was associated with plaque vulnerability but most studies were performed by assessing focal target plaque but not whole plaques from a coronary tree.
Methods: To evaluate of the relationship of plasma hs-CRP level and volumetric plaque composition of the coronary arterial tree, we performed ‘whole vessel” virtual histology-intravascular ultrasound (VH-IVUS) in 189 vessels of 63 patients.The components of atherosclerosis were classified as fibrous (FI), fibrous-fatty (FF), necrotic core (NC) and dense calcium (DC). Quantitative assessment of these plaque components and the presence of VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) in the coronary arterial trees were compared to hs-CRP levels in individuals. hs-CRP levels were measured before coronary angiogram and IVUS study.
Results: Forty-nine patients (77.8%) were diagnosed with acute coronary syndrome in this population. The mean and median values of hs-CRP were 0.43±1.52 mg/dl and 0.12 mg/dl,respectively. The total number of VH-TCFA was 2.5±1.9 per patient. The hs-CRP levels were positively correlated to mean plaque burden, total plaque volume index, volume index of FF and DC. But parameters of NC and the number of VH-TCFA were not related with hs-CRP level (Table). In multivariate analysis, the volume index of DC was most reliable factor to hs-CRP (β=5.490, CI=5.072-5.908, p≤0.001).
Conclusions: This three-vessel VH-IVUS presented that hs-CRP were related to the total atherosclerotic burden and the age (coronary calcium) but not vulnerable features (NC or VH-TCFA) of plaques in coronary arterial tree. Increased hs-CRP level as a biomarker to predict cardiovascular events might imply atherosclerosis severity of whole coronary tree but not current plaque vulnerability.
- © 2013 by American Heart Association, Inc.