Multiple Vascular Reactivity Measures Improves Our Ability to Predict Underlying Coronary Artery Disease

Abstract

patients haveNCPmay enhance cardiovascular risk factor management. We used coronary computed tomography angiography (CCTA) to identify NCP in asymptomatic patients at intermediate risk of coronary artery disease (CAD). Furthermore, we utilised lipidomic profiling to determine whether measuring serum lipids could help predict the presence of NCP in these patients. Methods: We performed 64-slice CCTA on 100 prospectively enrolled asymptomatic subjects (86% male, mean age 61± 6 years) at intermediate CAD risk according to the Framingham cardiovascular risk score. Plaque composition was classified as non-calcified, mixed or calcified and the percentage of coronary artery segments containing non-calcified or mixed plaque was determined for each patient. Serum lipid concentrations of more than 300 molecular species in 20 lipid classes were measured using liquid chromatography-mass spectrometry. Results: CCTA identified NCP in 66 patients. Of these patients, 17% of coronary artery segments containedNCP. No lipid class was significantly associated with the presence of NCP. However, the dihydroceramide (p= 0.003) and GM3 ganglioside (p= 0.002) lipid classes were significantly associated with the percentage of segments containingNCP, after adjusting for age, gender, bodymass index and blood pressure. Conclusions:Most patients at intermediate risk of CAD have non-calcified plaque, however, a significant proportion do not. Lipidomic profiling may assist in predicting which patients of this substantial population are likely to have a greater burden of NCP and, thus, require more aggressive cardiovascular risk factor modification. http://dx.doi.org/10.1016/j.hlc.2013.05.105