Abstract 3088: Association between Coronary Plaque Burden as Measured by Multidetector Computed Tomography and Inflammatory Biomarkers in Patients with Acute Chest Pain

Abstract

Objective: Both the extent of coronary artery disease (CAD) and increased levels of inflammatory markers are associated with cardiovascular risk. However, the association of these markers with different types of atherosclerotic plaque as detected by multidetector computed tomography (MDCT) is unknown. Methods: In this cross-sectional study, we examined consecutive patients who were admitted ith acute chest pain to the ED but had no evidence of ACS during their index hospitalization and 6- month follow up. All patients underwent contrast enhanced 64-slice coronary MDCT. Commercially available assays were used to determine the levels of hs-CRP, matrix metalloproteinase 2 and 9, oxidized low-density lipoprotein (ox-LDL), tumor necrosis factor alpha, interleukin-6, soluble E-selectin, and lipoprotein-associated phospholipase A2 at the time of initial ED triage. Two independent observers determined the extent of CAD (number of coronary segments containing calcified and/or non-calcified plaque). Log-transformed biomarkers associated with the extent of CAD were determined in univariate and multivariable regression analysis (adjusted for age, gender, body mass index, diabetes mellitus, smoking, hypertension, and hyperlipidemia/ use of cholesterol lowering medication). Results: We analyzed inflammatory biomarkers and extent of CAD in 78 patients (mean age: 51.2 years, 42% female). In univariate analysis, hs-CRP (r=0.24, >p=0.02), and ox-LDL (r=0.33, p=0.008) were significantly correlated to the extent of any plaque, and non-calcified plaque, respectively. In multivariable analysis only ox- LDL remained an independent predictor of the extent of non-calcified plaque (beta coefficient: 1.81, p=0.005). The models including traditional risk factors and hs-CRP or ox-LDL explained 34.3%, and 24.5% of the variability of overall, and non-calcified plaque burden, respectively. Conclusions : In this exploratory analysis, we found that in patients with acute chest pain levels of ox-LDL were independent predictors of the extent of non-calcified plaque as detected by MDCT. Further studies are needed to confirm a complementary role of local (plaque) and systemic biomarkers of atherosclerosis to identify subjects at high probability of ACS.