title: Cholesterol efflux capacity in humans with psoriasis is inversely related to non-calcified burden of coronary atherosclerosis.
abstract: OBJECTIVE
  Cholesterol efflux capacity (CEC) was recently shown to predict future cardiovascular (CV) events. Psoriasis both increases CV risk and impairs CEC. However, whether having poor CEC is associated with coronary plaque burden is currently unknown. We aimed to assess the cross-sectional relationship between coronary plaque burden assessed by quantitative coronary computed tomography angiography (CCTA) with CEC in a well-phenotyped psoriasis cohort.
  
  
  RESULTS
  Total burden and non-calcified burden (NCB) plaque indices were assessed in 101 consecutive psoriasis patients using quantitative software. Cholesterol efflux capacity was quantified using a cell-based ex vivo assay measuring the ability of apoB-depleted plasma to mobilize cholesterol from lipid-loaded macrophages. Cholesterol efflux capacity was inversely correlated with NCB (unadjusted β-coefficient -0.33; P < 0.001), and this relationship persisted after adjustment for CV risk factors (β -0.24; P < 0.001), HDL-C levels (β -0.22; P < 0.001), and apoA1 levels (β -0.19; P < 0.001). Finally, we observed a significant gender interaction (P < 0.001) whereby women with low CEC had higher NCB compared to men with low CEC.
  
  
  CONCLUSIONS
  We show that CEC is inversely associated with prevalent coronary plaque burden measured by quantitative CCTA. Low CEC may therefore be an important biomarker for subclinical coronary atherosclerosis in psoriasis.
  
  
  BACKGROUND
  NCT01778569.
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Taufiq
authors.initials: T
authors.lastname: Salahuddin
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Balaji
authors.initials: B
authors.lastname: Natarajan
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Playford
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Aditya A
authors.initials: AA
authors.lastname: Joshi
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Teague
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Masmoudi
authors.affiliation: National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Mariana
authors.initials: M
authors.lastname: Selwaness
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
authors.forename: Marcus Y
authors.initials: MY
authors.lastname: Chen
authors.affiliation: National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA nehal.mehta@nih.gov.
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Mehta
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications*; D012727:Sex Characteristics; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000175:diagnosis* / Q000209:etiology
chemical_list: D015415:Biomarkers; D002784:Cholesterol
keywords: Cholesterol efflux capacity (CEC); Coronary plaque burden; HDL efflux; Inflammatory atherogenesis; Lipids; Non-calcified plaque burden; Psoriasis; Quantitative coronary computed tomography angiography (CCTA)