Prediction of Progression of Coronary Atherosclerosis Using Molecular and Imaging Biomarkers

Conventional risk factors, such as hypertension, dyslipidemia, diabetes mellitus, smoking, and obesity, are associated with an increased risk of the onset and progression of atherosclerotic coronary artery disease (CAD).Coronary computed tomography angiography (CCTA) has become widely available in many general hospitals and has emerged as a potential noninvasive method worldwide, particularly in Japan.CCTA is a useful tool for screening CAD in patients clinically suspected to have CAD.Coronary atherosclerosis can be evaluated using volume rendering, multiplanar reformation, and cross-sectional images obtained using CCTA.However, the analysis of conventional risk factors alone is insufficient in predicting the presence of CAD and the onset of major adverse cardiovascular events (MACEs).Therefore, it is necessary to identify new biomarkers, including imaging and molecular biomarkers, related to the development and progression of atherosclerotic CAD.We performed CCTA at Fukuoka University Hospital (FU-CCTA registry) and identified various risk factors for CAD and MACEs.Here, we discuss new imaging techniques (visceral fat area/subcutaneous fat area, pericardial fat, and psoas major muscle index) and molecular biomarkers (pentraxin-3 and high-density lipoprotein functionality), in addition to conventional risk factors associated with the presence and severity of CAD or MACEs in patients who underwent CCTA.