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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Plasma biomarker levels and non-obstructive coronary artery disease determined by coronary computed tomography
Elin B Brolin1, Stefan Agewall2, Kerstin Cederlund1
1Department of Radiology, Karolinska University Hospital Huddinge and Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Insights
Higher cystatin C levels predict non-obstructive coronary artery disease (CAD) in individuals at low-to-intermediate cardiovascular disease (CVD) risk. This finding aids in early detection using coronary computed tomography angiography (CTA).
Area of Science:
- Cardiovascular Imaging
- Biomarkers
- Renal Function
Background:
- Coronary computed tomography angiography (CTA) and biomarkers offer prognostic value for cardiovascular disease (CVD) events.
- The association between lipid metabolism, inflammation, kidney function markers, and non-obstructive coronary artery disease (CAD) requires further investigation.
Purpose of the Study:
- To investigate if lipid metabolism, inflammation, and kidney function markers predict non-obstructive CAD detected by coronary CTA.
- Focus on a low-to-intermediate cardiovascular risk population.
Main Methods:
- Coronary CTA and laboratory tests were conducted on 115 subjects aged 45-70 years.
- Participants had low prevalence of CVD risk factors, low-to-intermediate Framingham risk, and normal or mildly reduced kidney function.
Main Results:
- 43% of subjects had no CAD on coronary CTA; 57% had CAD in at least one segment (<50% stenosis).
- Adiponectin showed an inverse association with CAD. Lipoprotein(a) and cystatin C were associated with CAD.
- Cystatin C independently predicted CAD (OR: 2.50) and correlated with the number of diseased segments (rs = 0.25, P<0.01).
Conclusions:
- Elevated plasma cystatin C levels are linked to non-obstructive CAD on coronary CTA.
- This association was observed in individuals with low-to-intermediate CVD risk and normal to mildly impaired kidney function.
Purpose:
Coronary computed tomography angiography (CTA) and several circulating biomarkers have prognostic value regarding cardiovascular disease (CVD) events, but their association is incompletely studied. We aimed to investigate whether markers of lipid metabolism, inflammation and kidney function could predict non-obstructive coronary artery disease (CAD) determined by coronary CTA, in a low-to-intermediate-risk group.
Methods:
Coronary CTA and laboratory testing were performed for 115 subjects (45-70 years), with low prevalence of CVD risk factors, predominantly low-to-intermediate Framingham risk and normal or mildly reduced kidney function.
Results:
Forty-nine (43%) had no CAD at coronary CTA, and 66 (57%) had CAD in ≥1 segment (stenosis < 50%). Adiponectin was inversely associated with CAD, and lipoprotein(a) and cystatin C were associated with CAD at coronary CTA. In multivariable logistic regression, cystatin C remained an independent predictor of CAD (OR: 2·50, 95% CI: 1·12-5·59). Cystatin C also correlated to the number of diseased segments (rs = 0·25, P<0·01).
Conclusion:
Higher plasma levels of cystatin C were associated with non-obstructive CAD at coronary CTA in subjects with low-to-intermediate CVD risk and normal to mildly reduced kidney function.
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