Chronic inflammatory diseases and coronary heart disease: Insights from cardiovascular CT

• Published in: Journal of cardiovascular computed tomography Vol. 16; no. 1; pp. 7 - 18
• Main Authors: Patel, Nidhi H., Dey, Amit K., Sorokin, Alexander V., Teklu, Meron, Petrole, Rylee, Zhou, Wunan, Mehta, Nehal N.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2022
• Subjects: Biologic therapy; Biomarkers; Computed Tomography Angiography; Coronary Angiography; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Humans; Inflammation; Non-calcified burden; Plaque, Atherosclerotic; Predictive Value of Tests; Subclinical atherosclerosis; Tomography, X-Ray Computed; Biomarkers; Inflammation; Subclinical atherosclerosis; Non-calcified burden; Coronary artery disease; Biologic therapy
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2021.06.003

Epidemiological and clinical studies have demonstrated a consistent relationship between increased systemic inflammation and increased risk of cardiovascular events. In chronic inflammatory states, traditional risk factors only partially account for the development of coronary artery disease (CAD) but underestimate total cardiovascular risk likely due to the residual risk of inflammation. Computed coronary tomography angiography (CCTA) may aid in risk stratification by noninvasively capturing early CAD, identifying high risk plaque morphology and quantifying plaque at baseline and in response to treatment. In this review, we focus on reviewing studies on subclinical atherosclerosis by CCTA in individuals with chronic inflammatory conditions including rheumatoid arthritis (RA), systemic lupus erythematous (SLE), human immunodeficiency virus (HIV) infection and psoriasis. We start with a brief review on the role of inflammation in atherosclerosis, highlight the utility of using CCTA to delineate vessel wall and plaque characteristics and discuss combining CCTA with laboratory studies and emerging technologies to complement traditional risk stratification in chronic inflammatory states.