Abstract P212: Reduced High-Density Lipoprotein Efflux in Psoriasis Relates to Increased Coronary Plaque Burden by Quantitative CT Angiography
INTRODUCTION: Psoriasis is known to increase cardiovascular risk, possibly due to the presence of inflammatory, lipid-rich, non-calcified plaques in the coronary arteries. Psoriasis is also known to decrease HDL activity. However, whether having abnormal or low-functioning HDL increases arterial disease is currently unknown.
HYPOTHESIS: We aimed to test our hypothesis that coronary plaque burden assessed by quantitative CT angiography is related to HDL efflux capacity and other cardiometabolic parameters in a well-phenotyped psoriasis cohort (NCT# 01778569).
METHODS: Psoriasis patients (N=67) underwent coronary CT angiography (Toshiba 320 slice). Coronary plaque was assessed using QAngio CT (Medis, The Netherlands). Total (TB), dense calcium (DCB), and non-calcified burden (NCB) plaque indices were calculated by dividing total vessel plaque volume by total vessel length. We also performed deep phenotyping for lipid markers including HDL efflux capacity and other cardiometabolic parameters.
RESULTS: The study population was middle aged (52.2 ± 12.4 yr), had relatively low Framingham Risk Score (median 4%, IQR 2-7%), and had normal Apo A1 (156 ± 26.3 mg/dL) and HDL levels (54 ± 17 mg/dL). However, HDL efflux capacity was similar to that in coronary artery disease (0.95 ± 0.17). In univariate regression, NCB increased as HDL efflux capacity decreased (β= -0.84, p=0.01) and was robust to adjustment for cardiometabolic risk factors (β= -0.67, p=0.03). Furthermore, when stratified by median HDL efflux (0.94), patients having lower HDL efflux capacity had higher TB and NCB (TB 3.80 ± 0.82, 4.17 ± 0.97 mm2, p=0.003; NCB 3.59 ± 0.68, 3.94 ± 0.75 mm2, p=0.001 in the low and high HDL efflux groups, respectively). Additional biologic relations in univariate regression are shown in Table 1.
CONCLUSIONS: We show that HDL efflux is negatively associated with coronary plaque burden measured by quantitative CT angiography. Low HDL efflux may therefore be a strong biomarker for subclinical coronary atherosclerosis.
Author Disclosures: T. Salahuddin: None. B. Natarajan: None. M. Selwaness: None. A. Sadek: None. M. Playford: None. J. Doveikis: None. D. Bluemke: None. N.N. Mehta: None.
- © 2015 by American Heart Association, Inc.