Cholesterol Efflux Capacity in Humans With Psoriasis Is Inversely Related to Non-Calcified Burden of Coronary Atherosclerosis

Eur Heart J. 2015 Oct 14;36(39):2662-5. doi: 10.1093/eurheartj/ehv339. Epub 2015 Jul 18.


Aims: Cholesterol efflux capacity (CEC) was recently shown to predict future cardiovascular (CV) events. Psoriasis both increases CV risk and impairs CEC. However, whether having poor CEC is associated with coronary plaque burden is currently unknown. We aimed to assess the cross-sectional relationship between coronary plaque burden assessed by quantitative coronary computed tomography angiography (CCTA) with CEC in a well-phenotyped psoriasis cohort.

Methods and results: Total burden and non-calcified burden (NCB) plaque indices were assessed in 101 consecutive psoriasis patients using quantitative software. Cholesterol efflux capacity was quantified using a cell-based ex vivo assay measuring the ability of apoB-depleted plasma to mobilize cholesterol from lipid-loaded macrophages. Cholesterol efflux capacity was inversely correlated with NCB (unadjusted β-coefficient -0.33; P < 0.001), and this relationship persisted after adjustment for CV risk factors (β -0.24; P < 0.001), HDL-C levels (β -0.22; P < 0.001), and apoA1 levels (β -0.19; P < 0.001). Finally, we observed a significant gender interaction (P < 0.001) whereby women with low CEC had higher NCB compared to men with low CEC.

Conclusions: We show that CEC is inversely associated with prevalent coronary plaque burden measured by quantitative CCTA. Low CEC may therefore be an important biomarker for subclinical coronary atherosclerosis in psoriasis.

Clinicaltrialsgov: NCT01778569.

Keywords: Cholesterol efflux capacity (CEC); Coronary plaque burden; HDL efflux; Inflammatory atherogenesis; Lipids; Non-calcified plaque burden; Psoriasis; Quantitative coronary computed tomography angiography (CCTA).

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / metabolism
  • Cholesterol / metabolism*
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / diagnosis*
  • Plaque, Atherosclerotic / etiology
  • Prospective Studies
  • Psoriasis / complications*
  • Sex Characteristics
  • Tomography, X-Ray Computed
  • Vascular Calcification / diagnosis*
  • Vascular Calcification / etiology


  • Biomarkers
  • Cholesterol

Associated data