Plasma biomarker levels and non-obstructive coronary artery disease determined by coronary computed tomography angiography.
OBJECTIVE
Coronary computed tomography angiography (CTA) and several circulating biomarkers have prognostic value regarding cardiovascular disease (CVD) events, but their association is incompletely studied. We aimed to investigate whether markers of lipid metabolism, inflammation and kidney function could predict non-obstructive coronary artery disease (CAD) determined by coronary CTA, in a low-to-intermediate-risk group.


METHODS
Coronary CTA and laboratory testing were performed for 115 subjects (45-70 years), with low prevalence of CVD risk factors, predominantly low-to-intermediate Framingham risk and normal or mildly reduced kidney function.


RESULTS
Forty-nine (43%) had no CAD at coronary CTA, and 66 (57%) had CAD in ≥1 segment (stenosis < 50%). Adiponectin was inversely associated with CAD, and lipoprotein(a) and cystatin C were associated with CAD at coronary CTA. In multivariable logistic regression, cystatin C remained an independent predictor of CAD (OR: 2·50, 95% CI: 1·12-5·59). Cystatin C also correlated to the number of diseased segments (rs= 0·25, P<0·01).


CONCLUSIONS
Higher plasma levels of cystatin C were associated with non-obstructive CAD at coronary CTA in subjects with low-to-intermediate CVD risk and normal to mildly reduced kidney function.
Department of Radiology, Karolinska University Hospital Huddinge and Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Elin B
EB
Brolin
Department of Cardiology, Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Oslo, Norway.
Stefan
S
Agewall
Department of Radiology, Karolinska University Hospital Huddinge and Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Kerstin
K
Cederlund
Department of Cardiology, Danderyd Hospital and Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Christina
C
Ekenbäck
Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Loghman
L
Henareh
Department of Cardiology, Danderyd Hospital and Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Karin
K
Malmqvist
Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Andreas
A
Rück
Department of Radiology, Karolinska University Hospital Huddinge and Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Anders
A
Svensson
Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Per
P
Tornvall
D000368:Aged; D015415:Biomarkers / Q000097:blood; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D055316:Cystatin C / Q000032:analysis*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C

CAD
; 
CTA
; 
MDCT
; Cystatin C; adiponectin; lipoprotein(a); plaque burden