Association between the Atherosclerotic Modifiable Risk Factor Burden and Coronary Inflammation

Area of Science:

• Cardiovascular Disease Research
• Atherosclerosis Pathophysiology
• Medical Imaging and Diagnostics

Background:

• The interplay between modifiable risk factors (RFs) and coronary inflammation is not fully understood.
• Coronary inflammation is a critical early event in atherosclerosis development.
• Investigating cumulative RF burden offers insights into early coronary artery disease (CAD) pathogenesis.

Purpose of the Study:

• To examine the association between the cumulative burden of modifiable RFs and coronary inflammation.
• To determine if this relationship is influenced by the degree of coronary artery stenosis.
• To clarify the role of RF clustering in early atherosclerosis.

Main Methods:

• Analysis of 958 patients undergoing coronary computed tomography angiography.
• Modifiable RFs assessed: hypertension, diabetes, obesity (BMI ≥ 30 kg/m²), and smoking.
• Coronary inflammation quantified using perivascular fat attenuation index (FAI); high FAI defined as > -70.2 HU.

Main Results:

• Higher RF burden correlated with increased prevalence of high FAI: 1 RF (RR 1.56) and ≥ 2 RFs (RR 1.71) compared to none.
• Significant association observed even in patients with minimal coronary plaque (<25% stenosis).
• Dose-dependent relationship between RF burden and coronary inflammation demonstrated.

Conclusions:

• Increased cumulative burden of modifiable RFs is dose-dependently associated with heightened coronary inflammation.
• RF clustering contributes to coronary inflammation irrespective of significant coronary plaque presence.
• Findings emphasize the importance of managing multiple RFs for preventing early atherosclerosis.