Novel plasma biomarkers of coronary artery calcium incidence or progression: Insights from the prospective multi-ethnic Dallas Heart Study cohort

Atherosclerosis. 2024 Mar:390:117469. doi: 10.1016/j.atherosclerosis.2024.117469. Epub 2024 Feb 1.

Abstract

Background and aims: Identifying the association of novel plasma biomarkers with coronary artery calcium (CAC) incidence or progression may provide insights into the pathophysiology of atherogenesis and plaque formation.

Methods: Participants of the Dallas Heart Study (DHS), a multi-ethnic cohort of ambulatory individuals at low-intermediate risk for future atherosclerotic cardiovascular disease (ASCVD), who had their blood tested for 31 biomarkers reflecting multiple pathophysiological pathways, underwent 2 serial non-contrast computed tomography assessments for CAC a median ∼7 years apart. The collected biomarkers were explored for association with CAC incidence or progression using univariate and multivariate analysis.

Results: A total of 1424 participants were included; mean age 43 years, 39 % male, and nearly half African-American. Over a 7-year interval between the two CAC measurements, 340 participants (23.9 %) had CAC incidence or progression, 105 (7.4 %) with incident CAC, and 309 (21.7 %) with CAC progression. Although several plasma biomarkers were associated with CAC incidence or progression in a univariate model, only soluble intercellular adhesion molecule-1 (sICAM-1), related to atherosclerosis by the inflammatory pathway, remained independently associated in a multivariate model adjusted for traditional risk factors.

Conclusions: Further studies are needed to characterize the role of sICAM-1 in CAC evolvement to establish whether it has a pivotal mechanistic contribution or is rather an innocent bystander. Alternate measures of coronary atherosclerosis may be needed to elucidate contributors to atherosclerosis incidence or progression.

Keywords: Atherogenesis; Atherosclerosis; Atherosclerotic cardiovascular disease; Biomarkers; Coronary artery calcium.

MeSH terms

  • Adult
  • Atherosclerosis* / metabolism
  • Biomarkers / metabolism
  • Calcium / metabolism
  • Calcium, Dietary
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / epidemiology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / metabolism
  • Female
  • Humans
  • Incidence
  • Male
  • Prospective Studies
  • Risk Factors
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / epidemiology
  • Vascular Calcification* / metabolism

Substances

  • Calcium
  • Biomarkers
  • Calcium, Dietary