Association of high-risk coronary atherosclerosis at CCTA with clinical and circulating biomarkers: Insight from CAPIRE study

Conte, Edoardo; Modena, Maria Grazia; Gorini, Marco; Maggioni, Aldo P.; Maseri, Attilio; Andreini, Daniele; Berti, Sérgio; Canestrari, Mauro; Casolo, Giancarlo; Gabrielli, Domenico; Latini, Roberto; Magnoni, Marco; Marraccini, Paolo; Masson, Serge; Moccetti, Tiziano; Modena, Maria Grazia; Gaspari, Flavio; Ferrari, Stefano; Cannatà, Antonio; Stucchi, Nadia; Fois, Matteo; Bernasconi, Roberto; Balconi, Giovanna; Vago, Tarcisio; Letizia, Teresa; Bottazzi, Barbara; Leone, Roberto; Suliman, Ihab; Gremigni, Paola; Olivieri, Rodrigo; Pennacchietti, Liliana; Magnacca, Massimo; Rossi, Michel; Pasotti, Elena; Clemente, Alberto; Mushtaq, Saima; Mauro, Ezequiel; Rossi, Rosario; Pigazzani, Filippo; Faggioni, Lorenzo; Ciardetti, Marco; Puppato, Michela

doi:10.1016/j.jcct.2020.03.005

Cited by 21 publications

(26 citation statements)

References 18 publications

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“…In the last decade, a high number of reports highlighted the presence of acute coronary syndrome (ACS) in the contest of nonob CAD. Up to now, the identification of HRPs is demanded to CCTA and, even if preliminary data on the CAPIRE study may suggest a potential association between HRP features and inflammatory markers (Conte et al, 2020a), the lack of circulating biomarkers associated with plaque instability constitutes a critical diagnostic issue.…”

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Morphodynamics: A New Potential Marker in High-Risk Patients

et al. 2021

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In the last years, a substantial contribution of red blood cells (RBCs) in cardiovascular homeostasis has been evidenced, as these cells are able to regulate cardiovascular function by the export of adenosine triphosphate and nitric oxide as well as to maintain redox balance through a well-developed antioxidant system. Recently a link between high-risk plaque (HRP) features and myocardial ischemia, in the absence of severe lumen stenosis, has been evidenced. Nonobstructive coronary artery disease (nonob CAD) has been associated in fact with a greater 1-year risk of myocardial infarction and all-cause mortality compared with no apparent CAD. This new evidence increases interest in searching new triggers to identify these high-risk patients, in the absence/or on top of traditional hazard markers. In this study, we investigated the existence of any association between RBC morphodynamics and HRP features in individuals with different grades of coronary stenosis detected by coronary computed tomography angiography (CCTA). Ninety-one consecutive individuals who underwent CCTA [33 no CAD; 26 nonobstructive (nonob), and 32 obstructive (ob) CAD] were enrolled. RBC morphodynamic features, i.e., RBC aggregability and deformability, were analyzed by means of Laser Assisted Optical Rotation Cell Analyzer (LoRRca MaxSis). The putative global RBC morphodynamic (RMD) score and the related risk chart, associating the extent of HRP (e.g., the non-calcified plaque volume) with both the RMD score and the max % stenosis were computed. In nonob CAD group only positive correlations between RBC rigidity, osmotic fragility or aggregability and HRP features (plaque necrotic core, fibro-fatty and fibro-fatty plus necrotic core plaque volumes) were highlighted. Interestingly, in this patient cohort three of these RBC morphodynamic features result to be independent predictors of the presence of non-calcified plaque volume in this patients group. The risk chart created shows that only in nonob CAD plaque vulnerability increases according to the score quartile. Findings of this work, by evidencing the association between erythrocyte morphodynamic characteristics assessed by LoRRca and plaque instability in a high-risk cohort of nonob CAD, suggest the use of these blood cell features in the identification of high-risk patients, in the absence of severe coronary stenosis.

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Section: Discussionmentioning

confidence: 99%

Red Blood Cell Morphodynamics: A New Potential Marker in High-Risk Patients

et al. 2021

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“…Concerning the association of hs-CRP with vascular disease, a connection between hs-CRP and atherosclerosis has long been established since hs-CRP directly binds oxidized low-density lipoprotein cholesterol (LDL-C) and has been shown to be present within atherosclerotic plaques. As a result, hs-CRP contributes to plaque instability and exerts a highly proatherogenic effect ( Singh et al, 2008 ; Conte E. et al, 2020 ). Moreover, hs-CRP has been associated with indices of vascular stiffness.…”

Section: Circulating Biomarkers Related To Vascular Agingmentioning

confidence: 99%

Pathophysiology of Circulating Biomarkers and Relationship With Vascular Aging: A Review of the Literature From VascAgeNet Group on Circulating Biomarkers, European Cooperation in Science and Technology Action 18216

et al. 2021

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Impairment of the arteries is a product of sustained exposure to various deleterious factors and progresses with time; a phenomenon inherent to vascular aging. Oxidative stress, inflammation, the accumulation of harmful agents in high cardiovascular risk conditions, changes to the extracellular matrix, and/or alterations of the epigenetic modification of molecules, are all vital pathophysiological processes proven to contribute to vascular aging, and also lead to changes in levels of associated circulating molecules. Many of these molecules are consequently recognized as markers of vascular impairment and accelerated vascular aging in clinical and research settings, however, for these molecules to be classified as biomarkers of vascular aging, further criteria must be met. In this paper, we conducted a scoping literature review identifying thirty of the most important, and eight less important, biomarkers of vascular aging. Herein, we overview a selection of the most important molecules connected with the above-mentioned pathological conditions and study their usefulness as circulating biomarkers of vascular aging.

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“…Moreover, several biomarkers like pentraxin, hs-CRP, and hs-Tn-I have been suggested to be associated with high-risk atherosclerosis at CCTA and may help physicians to select healthy but higher-risk subjects [ 46 ]. Results from the CAPIRE trial suggested that hscTnT could accurately identify diffuse CAD in patients without acute coronary syndrome or clinical history of CAD and could be considered predictive biomarkers of CAD to identify outlier patients among those with a low-risk-factor burden [ 46 ]; moreover, hs-CRP was found to be correlated with high-risk atherosclerosis at CCTA in a recent subanalysis of the CAPIRE trial [ 47 ].…”

Section: Future Perspectives For Potential Use Of Ccta In Primary mentioning

confidence: 99%

“…Statin therapy has been previously associated with an increase in calcified plaque subcomponents. This effect, called the “statin plaque paradox” with an increase of calcified plaque burden at the expense of fibro-lipidic subcomponents, has been described both at serial IVUS and CT evaluation and was associated with a plaque stabilization process [ 47 , 48 , 49 , 50 ]. Of note, the subsequent increase in coronary calcium burden after statin therapy makes CACS a suboptimal tool for the description of statin-related plaque effects.…”

Section: Future Perspectives For Potential Use Of Ccta In Primary mentioning

confidence: 99%

Potential Application of Cardiac Computed Tomography for Early Detection of Coronary Atherosclerosis: From Calcium Score to Advanced Atherosclerosis Analysis

Conte

Mushtaq

Marchetti

et al. 2021

JCM

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In the present article, an overview of advanced analysis of coronary atherosclerosis by coronary computed tomography angiography (CCTA) is provided, focusing on the potential application of this technique in a primary prevention setting. Coronary artery calcium score (CACS) has a well-demonstrated prognostic value even in a primary prevention setting; however, fibro-fatty, high-risk coronary plaque may be missed by this tool. On the contrary, even if not recommended for primary prevention in the general population, CCTA may enable early high-risk atherosclerosis detection, and specific subgroups of patients may benefit from its application. However, further studies are needed to determine the possible use of CCTA in a primary prevention setting.

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Association of high-risk coronary atherosclerosis at CCTA with clinical and circulating biomarkers: Insight from CAPIRE study

Cited by 21 publications

References 18 publications

Red Blood Cell Morphodynamics: A New Potential Marker in High-Risk Patients

Red Blood Cell Morphodynamics: A New Potential Marker in High-Risk Patients

Pathophysiology of Circulating Biomarkers and Relationship With Vascular Aging: A Review of the Literature From VascAgeNet Group on Circulating Biomarkers, European Cooperation in Science and Technology Action 18216

Potential Application of Cardiac Computed Tomography for Early Detection of Coronary Atherosclerosis: From Calcium Score to Advanced Atherosclerosis Analysis

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