Carotid intima‐media thickness and markers of inflammation, endothelial damage and hemostasis (original) (raw)
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C-reactive Protein and Carotid Intima-media Thickness in a Population of Middle-aged Koreans
Journal of preventive medicine and public health, 2009
Objectives : This study was performed to evaluate the relationship between C-reactive protein (CRP) and carotid intima-media thickness (carotid IMT) in a population of middle-aged Koreans. Methods : A total of 1,054 men and 1,595 women (aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause (women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. Results : Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women (p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men (p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women (p for trend=0.017), but not in men (p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55 (95% CI=1.06-2.26) in women, but only 1.05 (95% CI=0.69-1.62) in men. Conclusions : CRP and carotid IMT levels appear to be directly related in women, but not in men.
Haematologica, 2004
Fibrinogen has been found to be an independent risk factor for cardiovascular disease. The aim of this study was to validate the measurement of plasma fibrinogen as a marker of subclinical atherosclerosis in a series of asymptomatic subjects (n=519, median age 55.5 years, 80% men). All individuals had a complete clinical examination, lipid profile (cholesterol and its high and low density lipoprotein fractions and triglycerides), global vascular risk assessment (PROCAM), and B-mode ultrasonography of the carotid arteries to determine the intima-media thickness (IMT) and the presence of atheroma plaques. C-reactive protein (CRP), and von Willebrand factor (vWF) were also measured in all subjects as markers of inflammation/endothelial damage. In the univariate model, a positive relationship was found between plasma fibrinogen concentration and carotid IMT (p<0.001). Fibrinogen concentration also correlated positively with age (p<0.001), systolic blood pressure (p<0.001), smok...
Croatian Medical Journal, 2016
Aim To test if circulating levels of markers of inflammation, endothelial function, and chronic infections, as well as association between these markers and carotid intima media thickness (CIMT), depend on the stage of atherosclerosis expressed as a history of a major vascular event. Methods The associations were analyzed separately in 75 healthy controls, 79 patients 3-6 months after the first-ever non-cardioembolic ischemic stroke (IS), and 37 patients 3-6 months after the first-ever myocardial infarction (MI). Data were collected prospectively in 2005. We measured high sensitivity C-reactive protein (hs-CRP), procalcitonin, E-selectin, intercellular adhesion molecule-1 (ICAM-1), serum level of immune complexes (IC), and identified antibodies against Herpes simplex virus type 1 (HSV), Cytomegalovirus, Chlamydia pneumonia, and Helicobacter pylori. Correlations with CIMT were determined using Pearson R and verified after adjustment for age, sex, hypertension, diabetes, and statin therapy. Results Median ICAM-1 concentration was significantly lower in controls than in post-IS patients (188 μg/L vs 215 μg/L), and significantly lower in post-IS patients than in post-MI patients (215 μg/L vs 260 μg/L). Control patients also had significantly lower IC level (0.03 U/L) and HSV antibody index (6.0) compared to both post-IS (0.6 U/L, 9.6) and post-MI (0.4 U/L, 9.2) patients. CIMT was correlated with age (Pearson R = 0.38, P = 0.001) in the control group, immune complexes (R = 0.26, P = 0.023) in the post-IS group, and with hs-CRP (R = 0.40, P = 0.017) in the post-MI group. These correlations were confirmed using multiple regression analysis. Conclusions Our study supports linear correlations between CIMT and IC and hs-CRP levels. However, these associations seem to depend on the type of vascular burden.
Objective: C-reactive protein (CRP) and ESR are well-known inflammatory markers. Dyslipidemia are potent risk factors for cardiovascular disease, and carotid intima-medial thickness (CIMT) denotes subclinical atherosclerosis. Our aim was to assess the correlation between them in diabetic subjects. Materials and Methods: In this prospective observational study, we selected 78 subjects with type 2 diabetes and dyslipidaemia. The study period was 6 months. Carotid intima-medial thickness of the subjects was measured. The values correlated with the risk markers. Results: Mean age of the subjects was 55.1 year with a standard deviation of 12.1. Positive CRP (>6mg/L) was found in 56.41% patients and abnormal CIMT in 46.15%. Mean CIMT was 0.93 with a standard deviation of 0.3. CRP and ESR value positively correlated with CIMT where, p value was significant (<0.05). Subsequently high triglyceride and LDL values was found to be associated mostly with abnormal CIMT with significant correlation with a coefficient of 0.45 and 0.59 respectively with significant p value (<0.05). Conclusion: CRP and ESR are well-known markers of inflammation and can also be used as indicators of atherosclerosis as noted by our study. It also establishes that, dyslipidaemia underlies significant atherosclerosis.
Stroke, 2003
Background and Purpose-Several factors have been held responsible for the development of atherosclerosis. To avoid the masking effect of age, we evaluated correlates of carotid atherosclerosis in patients Ͻ55 years of age. Methods-Plasma lipids, oxidative resistance of low-density lipoprotein, homocysteine, inflammatory markers, plasma viscosity, and red cell deformability were measured in fasting blood samples of 100 subjects: 45 patients with Ͼ30% stenosis of the internal carotid artery, 20 patients with carotid occlusion, and 35 control subjects. Stenosis and intima-media thickness (IMT) of the carotid artery were evaluated by duplex ultrasound. Results-White blood cell (WBC) count, plasma fibrinogen, C-reactive protein (CRP), and lipoprotein(a) levels were significantly higher in patients than in control subjects, and patients had increased IMT (PϽ0.01 for all comparisons). There was a tendency for higher homocysteine levels in patients. Smokers had higher WBC, fibrinogen, and CRP levels.
Stroke, 2013
A therosclerosis and cardiovascular disease are the leading causes of death and disability in industrialized nations. 1 Carotid intima-media thickness (cIMT) was a widely accepted imaging marker of subclinical atherosclerosis in the past; 2-4 however, it is increasingly clear that IMT is a separate phenotype from carotid plaque, which is a focal lesion most likely determined by a set of different biological and genetic factors. Early detection of risk factors of cIMT and their early modification may have a significant impact on the prevention of atherosclerotic disease. Traditional and common vascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, and smoking, have been associated with increased cIMT. 2,3,5,7-9 Although these traditional vascular risk factors account for <50% of the variance of atherosclerotic plaque burden, 10-13 they may not explain such a high proportion of the variance in IMT, especially when measured in plaque freelocations. 4,14 The contribution of other less traditional factors, such as homocysteine, 15,16 kidney function, 17,18 and adiponectin, 19 to cIMT is less clear. Furthermore, because atherosclerosis is considered an inflammatory disease, 20 factors involved in inflammatory processes may be important determinants of increased cIMT, including white blood cell count, 21 C-reactive protein, 22 interleukin-6, 23 serum amyloid A, 24 and others.
Recent studies have indicated that lipoprotein(a) [Lp(a)] and fibrinogen are novel risk factors for systemic atherosclerosis. The main objective of this study was to evaluate the level of Lp(a) and fibrinogen in patients with essential hypertension. The study comprised 20 patients with arterial hypertension and dyslipidemia, 20 patients with arterial hypertension without dyslipidemia and 16 age- and sex-matched control subjects. In all patients, the plasma total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, non-HDL-cholesterol, TC/HDL-cholesterol ratio, LDL-cholesterol/HDL-cholesterol ratio, Lp(a) and fibrinogen levels were evaluated. Using B-mode ultrasonography, we evaluated carotid intima-media thickness (IMT). We found significant higher Lp(a) levels in hypertensive patients with or without comparative with the control group. The most elevated concentrations of fibrinogen were found in hypertensive group with dyslipidemia comparative with hypertensive group without dyslipidemia and with the control group. We found a strong positive correlation between Lp(a) and IMT (p < 0.001), and a moderate positive correlation between Lp(a) and fibrinogen (p < 0.001) and between fibrinogen and IMT (p < 0.001). The measurement of IMT could represent a simple and noninvasive method to monitor hypertensive subjects, with higher levels of Lp(a) and fibrinogen, indifferently of the status of traditionally dyslipidemic risk factors.
C-reactive protein, carotid intima-media thickness, and incidence of ischemic …
Circulation, 2003
From the Henry Ford Heart and Vascular Institute (JJC), Detroit, Mich; Merck Research Laboratory (CT), Rahway, NJ; National Heart, Lung, and Blood Institute (TAM), Bethesda, Md; University of Washington (BMP), Seattle, Wash; University of Pittsburgh (LHK, KS-T.), Pittsburgh, Pa; ...