Association between C-reactive Protein and type of coronary arterial plaque in asymptomatic patients: assessment with coronary CT angiography.
OBJECTIVE
To determine whether C-reactive protein is associated with the type of coronary plaque seen at computed tomographic (CT) angiography.


METHODS
The institutional review board approved this retrospective study, and the need for informed consent was waived. C-reactive protein levels were measured in 2653 asymptomatic subjects (mean age ± standard deviation, 54.7 years ± 9.2; 1811 men) who underwent self-referred coronary CT angiography as part of a general health checkup. The presence of coronary plaque, plaque type (calcified, mixed calcified, or noncalcified), stenosis degree, and number of involved segments were evaluated. Subjects with one type of plaque (calcified plaque, mixed plaque, and noncalcified plaque groups) and two or more types of plaque (multiple lesions group) were analyzed separately. Multivariate logistic regression analysis was used to evaluate the association between increasing C-reactive protein levels and plaque type.


RESULTS
Coronary plaque was found in 1150 of the 2653 subjects (43.3%): calcified plaque (n = 604, 22.8%), mixed plaque (n = 67, 2.5%), noncalcified plaque (n = 208, 7.8%), and multiple lesions (n = 271, 10.2%). The C-reactive protein cutoff value of the fourth quartile was 1.2 mg/L (11.4 nmol/L), and all types of coronary plaque were increased in the higher quartile of the C-reactive protein levels. Multivariate logistic regression analysis showed that a higher C-reactive protein level was an independent predictor for the presence of noncalcified plaque (fourth vs first quartile group, odds ratio = 1.70, P = .025) and significant (50% and higher) coronary stenosis (odds ratio = 1.76, P = .020) after adjustment for traditional risk factors for coronary artery disease.


CONCLUSIONS
C-reactive protein is associated with noncalcified coronary arterial plaque, as seen at coronary CT angiography in asymptomatic patients after adjustment for traditional risk factors.
From the Department of Radiology and Research Institute of Radiology (D.H.Y., J.W.K., T.H.L.), Health Screening and Promotion Center (H.K.K., J.C.), Department of Clinical Epidemiology and Biostatistics (S.B.), Department of Preventive Medicine (S.H.K.), and Department of Cardiology (G.M.P., Y.H.K.), Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea; Department of Radiology, Gangnam Severance Hospital, University of Yonsei, Seoul, South Korea (T.H.K.); and Center for Optoelectronic Biomedicine and Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan (W.Y.I.T.).
Dong Hyun
DH
Yang
Joon-Won
JW
Kang
Hong-Kyu
HK
Kim
Jaewon
J
Choe
Seunghee
S
Baek
Seon Ha
SH
Kim
Gyung-Min
GM
Park
Young-Hak
YH
Kim
Tae Hoon
TH
Kim
Wen-Yih Isaac
WY
Tseng
Tae-Hwan
TH
Lim
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D023921:Coronary Stenosis / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
D015415:Biomarkers; D002097:C-Reactive Protein