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Background

It was shown that CRP modifies ACSVD risk of Lipoprotein(a) (Lp(a)) although the mechanism is unclear. Few studies have utilized advanced imaging modalities to evaluate Lp(a)’s impact on plaque burden. AI-enabled CAD phenotyping of coronary computed tomographic angiograms (CCTA) allows for comprehensive evaluation of the coronary arteries.

Methods

At a single center, we examined the association between Lp(a) and coronary atherosclerosis in asymptomatic patients being evaluated for primary prevention of CAD, as well as the role that CRP plays in this relationship. Atherosclerosis imaging quantitative CT (AI-QCT) (Cleerly Labs, Cleerly Inc Denver CO) measured total, non-calcified, and low-density non-calcified plaque (LD-NCP) volume in mm3 as well as percent atheroma volume (%; PAV).

Results

AI-QCT was performed on 317 consecutive asymptomatic patients; 298 (94.0%) of whom also had a recent LP(a) and CRP (mean age 56.2 ± 8.9 yrs., 76.7% male). Lp(a) mean 71.1 ± 96.7, range 0.6-793 mg/dl; CRP mean 2.4 ± 8.1 range 0.1-87.0 mg/l. LD-NCP volume (mm3) increased with LP(a) quintiles (mean 2.3,1.9, 3.8, 2.4, 3.7 mm3). When dichotomized into groups with CRP threshold of 1.1 mg/l and LP(a) of 125 nmol/L; there was a significant relationship with increasing LD-NCP PAV% when both LP(a) and CRP were elevated (P = 0.0148) (Figure 1 below).

Conclusion

When both CRP and LP(a) are elevated, there is significant increase in LD-NCP volume, which may help explain the recently observed increase in ASCVD risk.

Footnotes

Poster Contributions

Poster Hall_Hall F

Sunday, March 5, 2023, 9:45 a.m.-10:30 a.m.

Session Title: Multimodality Imaging: Clinical Science 8

Abstract Category: 31. Multimodality Imaging: Clinical Science

Presentation Number: 1459-191