title: Relationship between serum IgG4 concentrations and atherosclerotic coronary plaques assessed by computed tomographic angiography.
abstract: BACKGROUND
  Immunoglobulin G4 (IgG4)-related immuno-inflammation has been suggested to affect the development of coronary artery atherosclerosis. The aim of this study was to analyze the association of serum IgG4 concentrations with calcified and non-calcified coronary plaques.
  
  
  METHODS
  Serum IgG4 concentrations were measured in 263 patients who underwent 320-slice coronary computed tomographic (CT) angiography. Vulnerable coronary plaques were evaluated for CT plaque characteristics, including low-density plaque (LDP), positive remodeling, and spotty calcification.
  
  
  RESULTS
  Serum concentrations of IgG4 were significantly higher in patients with non-calcified plaque (NCP) than in those without (32.2mg/dL vs. 23.7mg/dL, p=0.029). By contrast, the median serum IgG4 concentrations in patients with and without calcified plaque were 31.2mg/dL and 26.2mg/dL, respectively (p=0.107). Serum IgG4 concentrations were significantly elevated in patients with LDP (33.5mg/dL vs. 26.9mg/dL, p=0.002) and in those with positive remodeling (31.4mg/dL vs. 28.4mg/dL, p=0.039) than in those without. Patients with spotty calcification also had significantly higher serum IgG4 concentrations than those without (32.1mg/dL vs. 24.9mg/dL, p=0.049). In age- and gender-adjusted logistic regression analysis, the highest IgG4 quartile (≥56.7mg/dL) was significantly associated with LDP with an odds ratio of 2.49 (95% CI, 1.15-5.36, p=0.020).
  
  
  CONCLUSIONS
  Serum IgG4 concentrations were significantly associated with NCP, especially with LDP, suggesting that IgG4-related immuno-inflammation may play a role in coronary plaque vulnerability.
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan. Electronic address: asakamoto-tky@umin.ac.jp.
authors.forename: Aiko
authors.initials: A
authors.lastname: Sakamoto
authors.affiliation: Division of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan; Department of Cardiovascular Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Uehara
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Ando
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan; Jichi Medical University, Tochigi, Japan.
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D007074:Immunoglobulin G
keywords: Biomarkers; Coronary computed tomographic angiography; Coronary plaque vulnerability; IgG4; Immuno-inflammation