Does Vascular Calcification Accelerate Inflammation?: A Substudy of the dal-PLAQUE Trial.

Change log
Joshi, Francis R 
Rajani, Nikil K 
Abt, Markus 
Woodward, Mark 
Bucerius, Jan 

BACKGROUND: Atherosclerosis is an inflammatory condition with calcification apparent late in the disease process. The extent and progression of coronary calcification predict cardiovascular events. Relatively little is known about noncoronary vascular calcification. OBJECTIVES: This study investigated noncoronary vascular calcification and its influence on changes in vascular inflammation. METHODS: A total of 130 participants in the dal-PLAQUE (Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non-invasive multimodality imaging) study underwent fluorodeoxyglucose positron emission tomography/computed tomography at entry and at 6 months. Calcification of the ascending aorta, arch, carotid, and coronary arteries was quantified. Cardiovascular risk factors were related to arterial calcification. The influences of baseline calcification and drug therapy (dalcetrapib vs. placebo) on progression of calcification were determined. Finally, baseline calcification was related to changes in vascular inflammation. RESULTS: Age >65 years old was consistently associated with higher baseline calcium scores. Arch calcification trended to progress more in those with calcification at baseline (p = 0.055). There were no significant differences between progression of vascular calcification with dalcetrapib compared to that with placebo. Average carotid target-to-background ratio indexes declined over 6 months if carotid calcium was absent (single hottest slice [p = 0.037], mean of maximum target-to-background ratio [p = 0.010], and mean most diseased segment [p < 0.001]), but did not significantly change if calcification was present at baseline. CONCLUSIONS: Across multiple arterial regions, higher age is consistently associated with higher calcium scores. The presence of vascular calcification at baseline is associated with progressive calcification; in the carotid arteries, calcification appears to influence vascular inflammation. Dalcetrapib therapy did not affect vascular calcification.

atherosclerosis, carotid arteries, cholesterol, dalcetrapib, fluorine-18, fluorodeoxyglucose, positron emission tomography, Aged, Amides, Anticholesteremic Agents, Atherosclerosis, Esters, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multimodal Imaging, Positron-Emission Tomography, Risk Factors, Sulfhydryl Compounds, Tomography, X-Ray Computed, Vascular Calcification, Vasculitis
Journal Title
J Am Coll Cardiol
Conference Name
Journal ISSN
Volume Title
Elsevier BV
British Heart Foundation (None)
British Heart Foundation (None)
The study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. Some editorial assistance was provided by Prime Healthcare and was funded by F. Hoffmann-La Roche Ltd, Basel, Switzerland. Partial support is acknowledged from NIH/NHLBI R01 HL071021 (ZAF). We thank Elisabetta Damonte for helping with statistical analyses.