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Chronic inflammatory diseases and coronary heart disease: Insights from cardiovascular CT

Nidhi H Patel1, Amit K Dey1, Alexander V Sorokin1

  • 1National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.

Journal of Cardiovascular Computed Tomography
|July 6, 2021
PubMed

Insights

Systemic inflammation increases cardiovascular event risk, especially in chronic inflammatory conditions. Computed coronary tomography angiography (CCTA) helps assess subclinical atherosclerosis and cardiovascular risk in these patients.

Area of Science:

  • Cardiovascular Medicine
  • Inflammatory Diseases
  • Medical Imaging

Background:

  • Systemic inflammation is linked to increased cardiovascular events.
  • Traditional risk factors underestimate cardiovascular risk in chronic inflammatory states.
  • Inflammation contributes residual risk to coronary artery disease (CAD) development.

Purpose of the Study:

  • To review the role of computed coronary tomography angiography (CCTA) in assessing subclinical atherosclerosis in chronic inflammatory conditions.
  • To highlight CCTA's utility in identifying high-risk plaque morphology and quantifying plaque burden.
  • To discuss integrating CCTA with other methods for comprehensive cardiovascular risk stratification.

Main Methods:

  • Review of studies utilizing CCTA in patients with rheumatoid arthritis, systemic lupus erythematosus, HIV infection, and psoriasis.
  • Analysis of CCTA's ability to visualize vessel wall and plaque characteristics.
  • Discussion of combining CCTA with laboratory markers and emerging technologies.

Main Results:

  • CCTA noninvasively detects early CAD and characterizes plaque morphology.
  • CCTA quantifies plaque burden, useful for monitoring treatment response.
  • Studies show increased subclinical atherosclerosis in inflammatory conditions.

Conclusions:

  • CCTA is valuable for cardiovascular risk stratification in chronic inflammatory diseases.
  • Integrating CCTA with traditional risk factors and biomarkers improves risk assessment.
  • Further research can enhance CCTA's role in managing cardiovascular risk in these populations.

Keywords:
Biologic therapyBiomarkersCoronary artery diseaseInflammationNon-calcified burdenSubclinical atherosclerosis

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