Department of Vascular Medicine, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.
Department of Cardiology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Open Heart. 2024 Sep 19;11(2):e002773. doi: 10.1136/openhrt-2024-002773.
Inflammation plays a pivotal role in atherogenesis and is a causal risk factor for atherosclerotic cardiovascular disease. Non-invasive coronary CT angiography (CCTA) enables evaluation of coronary plaque phenotype. This study investigates the relationship between a comprehensive panel of inflammatory markers and short-term plaque progression on serial CCTA imaging, hypothesising that inflammation is associated with increased plaque volume.
A total of 161 patients aged ≥40 years with stable multivessel coronary artery disease were included, who underwent CCTA at baseline and 12 months follow-up. Baseline plasma levels of interleukin 6 (IL-6), high-sensitivity C-reactive protein and other inflammatory markers were measured. Plaque volumes were assessed using semiautomated software, calculating total, noncalcified, calcified and low-attenuation noncalcified plaque volumes. Linear regression models, adjusted for ASSIGN score, segment involvement score and body mass index, evaluated associations between inflammatory markers and plaque volume changes.
The mean±SD age was 65.4±8.4 years, with 129 (80.6%) male participants. Baseline total plaque volume was 1394 (1036, 1993) mm³. After 12 months, total plaque volume changed by 78 (-114, 244) mm³. IL-6 levels were associated with a 4.9% increase in total plaque volume (95% CI: 0.9 to 8.9, p=0.018) and a 4.8% increase in noncalcified plaque volume (95% CI: 0.7 to 8.9, p=0.022). No significant associations were observed for other inflammatory markers.
Plasma IL-6 levels are significantly associated with increased total and noncalcified short-term plaque progression in patients with stable coronary artery disease. This supports the potential of IL-6 as a target for reducing plaque progression and cardiovascular risk.
炎症在动脉粥样硬化形成中起着关键作用，是动脉粥样硬化性心血管疾病的因果风险因素。非侵入性冠状动脉 CT 血管造影（CCTA）能够评估冠状动脉斑块表型。本研究旨在探讨炎症标志物综合指标与冠状动脉粥样硬化性心脏病患者冠状动脉斑块进展的关系，假设炎症与斑块体积增加有关。
共纳入 161 名年龄≥40 岁的多支血管稳定型冠心病患者，在基线和 12 个月时进行 CCTA 检查。测量基线时白细胞介素 6（IL-6）、高敏 C 反应蛋白和其他炎症标志物的血浆水平。使用半自动软件评估斑块体积，计算总斑块体积、非钙化斑块体积、钙化斑块体积和低衰减非钙化斑块体积。采用线性回归模型，调整 ASSIGN 评分、节段受累评分和体重指数，评估炎症标志物与斑块体积变化的关系。
平均年龄为 65.4±8.4 岁，129 名（80.6%）男性患者。基线时总斑块体积为 1394（1036，1993）mm³。12 个月后，总斑块体积变化为 78（-114，244）mm³。IL-6 水平与总斑块体积增加 4.9%（95%CI：0.9 至 8.9，p=0.018）和非钙化斑块体积增加 4.8%（95%CI：0.7 至 8.9，p=0.022）相关。其他炎症标志物与总斑块体积或非钙化斑块体积无显著相关性。
稳定型冠心病患者的血浆 IL-6 水平与总斑块和非钙化短期斑块进展显著相关。这支持了 IL-6 作为减少斑块进展和心血管风险的靶点的潜力。
