HDL Cholesterol, Leptin and Interleukin-6 Are Independent Predictors of Coronary Atherosclerotic Burden and Plaque Composition Assessed by Coronary Ct Angiography in Patient With Stable Angina.

Introduction: Coronary CT angiography (CTA) has been used to develop a novel CTA risk score for risk stratification of individual patients with stable angina. The new score integrates several features of coronary artery disease (CAD), i.e. plaque location, severity, and composition on coronary segments basis. Hypothesis: We hypothesized that circulating biomarkers related with metabolism and inflammation could be associated with the CTA risk score and its components. Methods: In 429 patients (60.3 ±0.4 years, 268 males) with chronic chest pain, enrolled in the European EVINCI study and submitted to quantitative CTA, a panel of 17 biomarkers was evaluated. The CTA risk score was calculated to assess overall atherosclerotic burden based on plaque extent, severity, composition, and location. Univariate and multivariate analysis was used to identify biomarkers associated with the CTA score. Results: Only three biomarkers [HDL cholesterol, Interleukin (IL)-6 and leptin] were independent predictors of the overall atherosclerotic burden expressed by the CTA risk score (HDL: Coefficient - 0.129 (SE 0.03), p < 0.0001; IL-6: 1.330 (0.42), p = 0.0017; leptin: - 0.166 (0.05), p = 0.0011), even after correction for clinical variables and medications. Lower HDL cholesterol levels and higher IL-6 were associated with non-calcified and mixed plaques, while lower leptin with mixed and calcified plaques (Fig. A). Conclusions: In patients with stable angina, circulating biomarkers, expressing abnormal cholesterol and lipid profiles as well as enhanced inflammatory process, are independently associated with the overall coronary atherosclerotic burden assessed by an integrated CTA risk score. HDL cholesterol and IL6 are markers of more vulnerable plaque types.