Abstract 12067: Serum Immunoglobulin G4 Level is a Useful Marker for the Assessment of Low-Density Coronary Plaque
Objective: Rupture of atherosclerotic coronary plaque is the most frequent cause of acute coronary syndrome. Although an immuno-inflammatory process is recognized to play a crucial role in the pathogenesis of atherosclerosis, it remains unclear whether immunoglobulin G4 (IgG4)-related immuno-inflammation is associated with coronary plaque vulnerability. The association between serum IgG4 levels and low-density plaque (LDP) was analyzed.
Methods: We measured serum levels of IgG4 and high-sensitivity C-reactive protein (hsCRP) in 325 patients (193 males; mean age, 68.2 ± 10.8 years) who underwent 320-slice coronary computed tomography angiography (CCTA). The presence or absence of LDP was evaluated, and epicardial fat volume (EFV) was also calculated.
Results: A total of 130 patients (40.0%) were judged to have LDP by CCTA. Serum levels of IgG4 and hsCRP were both significantly higher in patients with LDP than in those without (IgG4, 32.4 mg/dL [interquartile range, IR 18.6-81.2] vs. 24.0 mg/dL [IR 13.2-49.0], P=0.002; hsCRP, 0.10 mg/dL [IR 0.05-0.23] vs. 0.07 mg/dL [IR 0.03-0.15], P=0.008). The median of EFV was significantly greater in patients with LDP than in those without (112 mL [IR 78-148] vs. 94 mL [IR 74-127], P=0.011). EFV had a significant association with serum levels of IgG4 (R=0.117, P=0.035) and hsCRP (R=0.200, P<0.001). In logistic regression analysis using age, gender, EFV, serum hsCRP levels, estimated glomerular filtration rate (eGFR), smoking, hypertension, dyslipidemia, and diabetes as covariates, the fourth quartile of IgG4 (≥56.7 mg/dL) was significantly associated with LDP with an odds ratio of 2.15 (95% confidence interval 1.07-4.34, P=0.032).
Conclusions: Serum levels of IgG4 were significantly associated with LDP, and this relationship was, at least in part, independent of traditional cardiovascular risk factors and serum hsCRP levels. IgG4-related immuno-inflammation may affect coronary plaque vulnerability.
Author Disclosures: A. Sakamoto: None. N. Ishizaka: None. J. Ando: None. M. Uehara: None. R. Nagai: None. I. Komuro: None.
- © 2014 by American Heart Association, Inc.