Intermediate monocytes are associated with moderate-high risk coronary artery calcium scoring

Coronary artery calcium scoring (CCS) is a valuable non-invasive method for assessing atherosclerosis and performing risk stratification in patients with suspected coronary artery disease (CAD). Monocyte subsets play distinct roles in chronic inflammation and cardiovascular disease, potentially serving as biomarkers for CCS risk assessment. The aim of this study was to analyze the distribution of monocyte subsets in patients with suspected CAD and determine the association of monocyte subsets with CCS.A cohort of 182 individuals with suspected CAD was enrolled. Participants were stratified into three groups based on their CCS scores: very low-risk (CCS = 0), low-risk (CCS = 1-99), and moderate-high risk (CCS ≥ 100). Monocyte subsets were categorized according to CD14 and CD16 expression levels into classical, intermediate (intMo), and non-classical monocytes. Absolute counts and frequency distribution of monocyte subsets (FDMS, percentage of CD45+/CD14+/CD16+ events) were analyzed across all participants.Patients in the moderate-high risk CCS group had significantly higher absolute circulating monocyte counts than those in the other two groups (p < 0.05). Furthermore, the moderate-high risk CCS group had the highest absolute intMo count and FDMS (percentage of CD45+/CD14+/CD16+ events, p < 0.05). Both the absolute intMo count (Model 1: odds ratio [OR] = 1.024, 95% confidence interval [CI]: 1.009-1.040, p = 0.002) and FDMS (percentage of CD45+/CD14+/CD16+ events, Model 2: OR = 1.109, 95% CI = 1.039-1.183, p = 0.002) were identified as independent risk factors for moderate-high risk CCS.These data suggest that intMo may be a useful biomarker for CCS risk stratification.