Inflammation and early atherosclerosis beyond traditional risk factors: an imaging study.

Higher white blood cell count is strongly associated with greater 6-year subclinical atherosclerosis plaque burden in 3,471 middle-aged asymptomatic participants, increasing global plaque volume by 32.6% per 1 SD.

• Why it matters: Inflammation’s role in subclinical plaque accumulation beyond established cardiovascular risk factors is unclear, limiting how well prevention strategies can target inflammatory pathways.
• What they did: In the PESA cohort (median age 45), serial blood tests and non-invasive imaging were collected at baseline, 3, and 6 years; global plaque volume at 6 years (carotid plus femoral) was modeled with multivariable regression.
• The result: Global plaque volume at 6 years rose with baseline LDLc (40.9% per 1 SD) and mean SBP (42.7% per 1 SD), and also with fibrinogen (16.8% per 1 SD), while high-sensitivity C-reactive protein was not predictive.

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