Association of high-risk coronary atherosclerosis at CCTA with clinical and circulating biomarkers: Insight from CAPIRE study

J Cardiovasc Comput Tomogr. 2021 Jan-Feb;15(1):73-80. doi: 10.1016/j.jcct.2020.03.005. Epub 2020 Jun 11.

Abstract

Background: High-risk coronary atherosclerosis features evaluated coronary CT angiography (CCTA) were suggested to have a prognostic role. The present study aimed to evaluate the association of circulating biomarkers with high-risk plaque features assessed by CCTA.

Methods: A consecutive cohort of subjects who underwent CCTA because of suspected CAD was screened for inclusion in the CAPIRE study. Based on risk factors (RF) burden patients were defined as having a low clinical risk (0-1 RF with the exclusion of patients with diabetes mellitus as single RF) or an high clinical risk (≥3 RFs). In all patients, measurement of inflammatory biomarkers and CCTA analysis focused on high-risk plaque features were performed. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between clinical and biological variables with CCTA advanced plaque features.

Results: 528 patients were enrolled in CAPIRE study. Older age and male sex appeared to be predictors of qualitative high-risk plaque features and associated with the presence of elevated total, non-calcified and low-attenuation plaque volume. Among circulating biomarkers only hs-CRP was found to be associated with qualitative high-risk plaque features (OR 2.02, p = 0.004 and 2.02, p = 0.012 for LAP and RI > 1.1, respectively) with borderline association with LAP-Vol (OR 1.52, p = 0.076); HbA1c and PTX-3 resulted to be significantly associated with quantitative high-risk plaque features (OR 1.71, p = 0.003 and 1.04, p = 0.002 for LAP-Vol, respectively).

Conclusions: Our results support the association between inflammatory biomarkers (hs-CRP, PTX- 3), HbA1c and high-risk atherosclerotic features detected by CCTA. Male sex and older age are significant predictors of high-risk atherosclerosis.

Keywords: Cardiac computed tomography; Cardiovascular prevention; Coronary atherosclerosis; Coronary plaque; High-risk plaque features; Inflammation.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Computed Tomography Angiography*
  • Coronary Angiography*
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / epidemiology
  • Cross-Sectional Studies
  • Female
  • Glycated Hemoglobin / analysis*
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Plaque, Atherosclerotic
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Serum Amyloid P-Component / analysis*
  • Sex Factors

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Serum Amyloid P-Component
  • hemoglobin A1c protein, human
  • PTX3 protein
  • C-Reactive Protein