Vatsa Nishant, Quintana Raymundo A, Doeberitz Phillipp Knebel, Onnis Carlotta, Vatsa Sonika, Newman Noah, Kauser Tanveer, Rahbar Alireza, Gold Daniel A, Jain Vardhmaan, Gold Matthew E, Razavi Alexander, Yadalam Adithya, Mehta Christina, Bedi Brahmchetna, Nguyen Tran B, Moran Caitlin A, Michopoulos Vasiliki, Hagen Kimbi, Ofotokun Ighovwerha, Lahiri Cecile D, Vaccarino Viola, Sperling Laurence S, Mehta Puja K, Van Assen Marly, De Cecco Carlo N, Quyyumi Arshed A
Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, USA.
Am J Prev Cardiol. 2025 Aug 22;23:101264. doi: 10.1016/j.ajpc.2025.101264. eCollection 2025 Sep.
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.
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.
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).
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.
In asymptomatic, predominately Black women, IL-6 mediated inflammation is associated with a greater likelihood of the presence of HRP.
冠状动脉高危斑块（HRP）与有症状的冠状动脉疾病（CAD）患者的炎症及不良结局相关，但在无已知CAD的无症状个体中，HRP的决定因素仍不明确。
我们研究了无已知CAD的无症状女性中白细胞介素6（IL-6）水平与HRP之间的关联，并假设较高的IL-6水平将与HRP相关。
我们在参加亚特兰大妇女机构间HIV研究的77名无已知CAD的女性中测量了血清IL-6水平，并进行了冠状动脉计算机断层扫描血管造影（CCTA）（中位年龄54岁，92.2%为黑人，67.5%感染HIV）。在视觉或半自动分析中具有斑点状钙化、餐巾环征、低衰减或冠状动脉斑块正性重构特征的患者被归类为患有HRP。我们使用了针对临床和社会人口统计学危险因素或合并队列方程（PCE）进行调整的逻辑回归模型。
PCE评分中位数为5.4%，IL-6水平中位数为2.18[1.33，3.59]pg/mL，51.9%的患者在CCTA上有冠状动脉斑块，38.9%有HRP。IL-6浓度处于最高四分位数（IL-6>3.59 pg/mL）的女性比处于较低四分位数的女性更有可能患有HRP（63.2%对31%，p=0.01）。IL-6水平与HRP患病率相关，独立于心血管危险因素（比值比[95%置信区间]：1.43[1.12，1.92]，p=0.008）或PCE评分（比值比：1.36[1.09，1.77]，p=0.01）或HIV状态。
在无症状的、以黑人为主的女性中，IL-6介导的炎症与HRP存在的可能性更大相关。
