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Interleukin-6 is associated with high-risk plaque on coronary computed tomography angiography in asymptomatic women
Nishant Vatsa1, Raymundo A Quintana2, Phillipp Knebel Doeberitz3
1Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
In asymptomatic women, higher levels of interleukin 6 (IL-6) inflammation are linked to a greater likelihood of high-risk plaque (HRP). This finding highlights IL-6 as a potential marker for coronary artery disease risk in this population.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Medical Imaging
Background:
- Coronary high-risk plaque (HRP) is linked to inflammation and adverse outcomes in symptomatic patients with coronary artery disease (CAD).
- Determinants of HRP in asymptomatic individuals without known CAD are not well understood.
- Inflammation, specifically interleukin 6 (IL-6), is a key factor in CAD pathogenesis.
Purpose of the Study:
- To investigate the association between serum IL-6 levels and the presence of HRP in asymptomatic women without known CAD.
- To test the hypothesis that higher IL-6 levels correlate with increased HRP prevalence.
- To identify potential inflammatory markers for subclinical coronary atherosclerosis.
Main Methods:
- Serum IL-6 levels and Coronary Computed Tomography Angiography (CCTA) were assessed in 77 asymptomatic women (Atlanta Women's Interagency HIV Study).
- HRP was identified by specific plaque features on CCTA (e.g., spotty calcification, napkin ring sign, low attenuation, positive remodeling).
- Logistic regression models were used, adjusting for clinical/sociodemographic factors and the Pooled Cohort Equation (PCE) score.
Main Results:
- Over half of the women (51.9%) had coronary plaque, and 38.9% exhibited HRP on CCTA.
- Women in the top quartile of IL-6 levels (>3.59 pg/mL) showed a significantly higher prevalence of HRP (63.2%) compared to those in lower quartiles (31%, p=0.01).
- Elevated IL-6 levels were independently associated with HRP prevalence, irrespective of cardiovascular risk factors, PCE score, or HIV status (OR: 1.43 [1.12, 1.92], p=0.008).
Conclusions:
- Interleukin 6 (IL-6) mediated inflammation is significantly associated with a higher likelihood of high-risk plaque (HRP) in asymptomatic women.
- These findings suggest IL-6 may serve as a valuable biomarker for identifying subclinical coronary atherosclerosis in this demographic.
- The study emphasizes the role of inflammation in the development of high-risk plaque, even in the absence of diagnosed CAD.
Background:
Coronary high-risk plaque (HRP) is associated with inflammation and adverse outcomes in symptomatic individuals with coronary artery disease (CAD), yet determinants of HRP in asymptomatic individuals without known CAD remain ambiguous.
Objectives:
We examined the association between interleukin 6 (IL-6) levels and HRP in asymptomatic women without known CAD and hypothesized higher IL-6 levels will be associated with HRP.
Methods:
We measured serum IL-6 levels and performed Coronary Computed Tomography Angiography (CCTA) in 77 women without known CAD enrolled in the Atlanta Women's Interagency HIV Study (median age 54, 92.2% Black, 67.5% living with HIV). Those with spotty calcification, napkin ring sign, low attenuation, or positive remodeling coronary plaque features on visual or semi-automated analyses were categorized as having HRP. We used logistic regression models adjusted for clinical and sociodemographic risk factors or the pooled cohort equation (PCE).
Results:
The median PCE score was 5.4%, the median IL-6 level was 2.18 [1.33, 3.59] pg/mL, 51.9% had coronary plaque and 38.9% had HRP on CCTA. Women with IL-6 concentrations in the top quartile (IL-6 > 3.59 pg/mL) were more likely to have HRP than those in lower quartiles (63.2%¦vs. 31%, p=0.01). IL-6 levels were associated with HRP prevalence, independent of cardiovascular risk factors (OR [95% CI]: 1.43 [1.12, 1.92], p=0.008) or PCE score (OR: 1.36 [1.09, 1.77], p=0.01) or HIV status.
Conclusion:
In asymptomatic, predominately Black women, IL-6 mediated inflammation is associated with a greater likelihood of the presence of HRP.
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