Related Experiment Video
Updated: Jul 4, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Markers of inflammation and coronary artery calcification: a systematic review
Yasmin S Hamirani1, Shivda Pandey, Juan J Rivera
1Department of Internal Medicine, St. Agnes Hospital, Baltimore, MD, USA.
Insights
Inflammatory markers show a weak association with coronary artery calcium (CAC) burden, often disappearing when corrected for obesity. These markers are not reliable sole predictors of future coronary heart disease (CHD) events.
Area of Science:
- Cardiovascular Disease Research
- Biomarker Discovery
- Atherosclerosis Studies
Background:
- Subclinical inflammation and atherosclerosis markers aid in identifying high-risk individuals for cardiovascular disease.
- Coronary artery calcium (CAC) quantifies coronary atherosclerosis and predicts future coronary heart disease (CHD) events.
- The link between subclinical inflammatory markers and the extent of coronary atherosclerosis remains unclear.
Purpose of the Study:
- To systematically review the cross-sectional association between inflammatory markers and coronary artery calcium (CAC).
- To determine if inflammatory markers can identify asymptomatic individuals at higher risk for coronary heart disease (CHD).
Main Methods:
- A systematic literature search was conducted on Medline and PubMed for studies published up to July 2007.
- Studies assessing the relationship between inflammatory markers and CAC were included.
- Various inflammatory markers were analyzed, including CRP, fibrinogen, MMP-9, MCP-1, resistin, Lp-PLA(2), IL-6, TNF-alpha, and bFGF.
Main Results:
- Twelve studies met the inclusion criteria, analyzing diverse inflammatory markers.
- A weak association between inflammatory markers and CAC was observed in most studies, primarily in women during univariate analysis.
- This association was lost after adjusting for obesity and body mass index (BMI).
- Data on inflammation, CAC, and atherosclerosis progression was scarce and showed no predictive benefit for future CHD.
Conclusions:
- Variable associations were found between CAC and inflammatory markers.
- Positive relationships often disappeared after correcting for traditional risk factors.
- Inflammatory markers are better suited for risk stratification in established coronary artery disease rather than sole predictors of future CHD events.
- Further comprehensive studies are needed to clarify the combined role of inflammatory markers in assessing atherosclerotic disease.
Objectives:
The goal of this systematic review is to assess the cross-sectional relationship of inflammatory markers with the presence and extent of coronary artery calcium (CAC) to identify asymptomatic individuals with a higher risk of coronary heart disease (CHD).
Background:
Markers of subclinical inflammation and subclinical atherosclerosis have both been used to improve detection of individuals at high risk of developing cardiovascular disease. CAC has emerged as a surrogate maker for underlying coronary atherosclerosis, and has been shown to predict future CHD events. Although inflammation is intimately associated with atherosclerosis, and levels of inflammatory markers predict cardiovascular risk, the relationship of subclinical inflammatory markers with the burden of coronary atherosclerosis is not clear.
Methods:
Medline and Pub Med databases were searched for all studies assessing the relationship of inflammatory markers with CAC published till July 2007.
Results:
We found 12 studies that met our criteria. CRP, fibrinogen, metallic metalloproteinase-9 (MMP-9), monocyte chemotactic protein 1 (MCP-1), resistin, lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), IL-6, tumor necrosis factor alpha (TNF-alpha) and beta-fibroblast growth factor (bFGF) were used as inflammatory markers. There was a wide variation among studies with regards to population size, inclusion criterias, age range and techniques. It was observed that in almost all studies the relationship between inflammatory markers and CAC was weak, and was mostly found upon univariate analysis in women. However, this association was lost after correction for obesity and BMI. The data on the relationship of inflammation and CAC with progression of atherosclerosis is scarce and did not show any predictive benefits for future CHD.
Conclusion:
Variable associations between CAC and inflammatory markers were identified. In most studies where a positive relationship was found, this relationship disappeared after appropriate correction for the presence of traditional risk factors. Our data suggests that an approach in which inflammatory markers are used to further characterize risk in individuals with an established coronary artery disease burden is more warranted than using biomarkers as sole risk predictors of future CHD events. Large, well-planned comprehensive studies are required to identify the combined role of measuring inflammatory markers in assessment of atherosclerotic disease.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:26Coronary Artery Disease IV: Preventive Measures
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...