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

Francis R. Joshi, Nikil K. Rajani, Markus Abt, Mark Woodward, Jan Bucerius, Venkatesh Mani, Ahmed Tawakol, David Kallend, Zahi A. Fayad, James H. F. Rudd*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.
Original languageEnglish
Pages (from-to)69-78
JournalJournal of the American College of Cardiology
Issue number1
Publication statusPublished - 5 Jan 2016


  • atherosclerosis
  • carotid arteries
  • cholesterol
  • dalcetrapib
  • fluorodeoxyglucose
  • fluorine-18
  • positron emission tomography


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