关键词: Cardiac computed tomography Cardiovascular prevention Coronary atherosclerosis Coronary plaque High-risk plaque features Inflammation

Mesh : Age Factors Aged Biomarkers / blood C-Reactive Protein / analysis Computed Tomography Angiography Coronary Angiography Coronary Artery Disease / blood diagnostic imaging epidemiology Cross-Sectional Studies Female Glycated Hemoglobin A / 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

来  源:   DOI:10.1016/j.jcct.2020.03.005   PDF(Sci-hub)

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.
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