Impact of inflammatory factors on coronary CT calcification score: correlation with plaque stability and evaluation of diagnostic efficiency

OBJECTIVE: To investigate the correlation between inflammatory cytokines (IL-1β, IL-6, and IL-10) and plaque stability as assessed by coronary computed tomography angiography (CTA) calcium scoring. METHODS: A retrospective study was conducted in 148 patients who underwent coronary angiography in the Department of Cardiovascular Medicine of our hospital from January 2022 to December 2024. Patients were classified into a coronary heart disease (CHD) group (n = 102) and a non-CHD group (n = 46). Coronary CTA calcium scores, biochemical parameters, serum cytokine levels (IL-1β, IL-6, IL-10), and plaque stability-related markers - including lipoprotein-associated phospholipase A2 (Lp-PLA2), lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), cathepsin K (CTSK), and pentraxin 3 (PTX3) - were compared between the groups. Patients were further stratified according to the Synergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) score into mild-to-moderate and severe coronary artery disease subgroups. Correlations among inflammatory cytokines, SYNTAX score, and plaque stability-related markers were assessed and compared between the groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of inflammatory cytokines for CHD. RESULTS: Significant differences were observed in peripheral blood levels of IL-1β, IL-6, and IL-10 between the CHD and non-CHD groups (all P < 0.05). IL-1β and IL-6 were positively correlated with both SYNTAX scores and plaque stability-related markers. ROC analysis revealed that IL-1β had an area under the curve (AUC) of 0.754 (95% CI: 0.631-0.877, P < 0.05) with an optimal cutoff of 4.86, yielding a sensitivity of 68.6% and specificity of 89.7%. IL-6 showed an AUC of 0.746 (95% CI: 0.631-0.860, P < 0.05) with a cutoff of 6.74, corresponding to a sensitivity of 82.9% and specificity of 66.7%. CONCLUSION: Inflammatory factors are important contributors to the development and progression of CHD. Their levels are significantly correlated with coronary calcium scores and plaque stability-related markers, and they demonstrate favorable diagnostic performance, suggesting potential clinical utility.