Highlights
- •Atherosclerosis is a complex phenomenon manifesting several features typical of chronic inflammation and disorders of lipid metabolism.
- •This study evaluates the association of inflammatory markers and specialized lipoprotein particles with incident coronary artery calcium (CAC) development and CAC progression over time.
- •Inflammatory markers and specialized lipoprotein particles were associated with CAC incidence and progression in minimally adjusted models, but not after adjustment for traditional risk factors.
- •Traditional risk factors were strongly associated with both CAC incidence and progression with the exception of cholesterol parameters not associated with CAC progression in adjusted model.
Abstract
Background and aims
Atherosclerosis is a complex phenomenon manifesting several features typical of chronic
inflammation and disorders of lipid metabolism. We assessed association of nuclear
magnetic resonance (NMR) lipid variables and inflammatory markers with incident coronary
artery calcium (CAC) and CAC progression among participants with baseline CAC ≥0.
Methods
MESA is a longitudinal cohort study of 6,814 participants (aged 45–85). 3,115 had
CAC = 0 and 2,896 had CAC>0 at baseline. Repeat CAC measurements were obtained (mean
duration of follow up, 6.5 years).
Results
IL-6 (log pg/mL) and fibrinogen (50 mg/dL) were associated with a higher relative
risk (RR) of incident CAC (HU) (RR = 1.09, p=0.010 & RR 1.05, p=0.004, respectively). Small LDL (100 nmol/L) (RR = 1.03, p<0.001) and log large VLDL (log nmol/L) (RR = 1.06, p=0.001) were associated with higher risks, whereas large HDL (μmol/L) was associated
with an inverse risk of incident CAC (RR = 0.97, p< 0.001) in a model adjusted for follow up time, age, gender and race. Among participants
with baseline CAC>0, progression of CAC was positively associated with hsCRP (log
mg/L) (β = 1.99), IL-6 (log pg/mL) (β = 2.9), fibrinogen (50 mg/dL) (β = 1.0), large
VLDL (log nmol/L) (β = 2.2), and small LDL (100 nmol/L) (β = 0.36) (all p values < 0.05) in a model adjusted for scanner type, age, gender and race. Relationships
with inflammatory markers and NMR lipoprotein particles lost significance after adjustment
for traditional risk factors and statin use. Traditional risk factors were strongly
associated with both CAC incidence and progression with the exception of cholesterol
parameters not associated with CAC progression in adjusted model.
Conclusions
Inflammatory markers and lipoprotein particles were associated with CAC incidence
and progression in minimally adjusted models, but not after adjustment for traditional
risk factors.
Keywords
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Article Info
Publication History
Published online: November 03, 2021
Accepted:
November 3,
2021
Received in revised form:
August 15,
2021
Received:
February 23,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
