Association between high sensitivity C-Reactive protein and prevalence of asymptomatic carotid artery stenosis

Huang, Xiaoya; Wang, Anxin; Liu, Xiaoxue; Chen, Shengyun; Zhu, Ying; Liu, Yanfang; Huang, Keyu; Wu, Jianwei; Chen, Shouhua; Wu, Shouling; Zhao, Xingquan

doi:10.1016/j.atherosclerosis.2015.12.024

Cited by 19 publications

(16 citation statements)

References 40 publications

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“…These findings might apparently be in contrast with previous studies demonstrating that serum CRP levels were positively associated with plaque vulnerability parameters [28–30]. On the other hand, CRP was already demonstrated to localize within early atherosclerotic plaques in human coronary arteries [31].…”

Section: Discussioncontrasting

confidence: 91%

Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

Bonaventura

Mach

Roth

et al. 2016

Mediators of Inflammation

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Serum c-reactive protein (CRP) was suggested for the assessment of intermediate cardiovascular (CV) risk. Here, systemic or intraplaque CRP levels were investigated as predictors of major adverse cardiovascular events (MACEs) in patients with severe carotid stenosis. CRP levels were assessed in the serum and within different portions (upstream and downstream) of carotid plaques of 217 patients undergoing endarterectomy. The association between CRP and intraplaque lipids, collagen, neutrophils, smooth muscle cells (SMC), and macrophage subsets was determined. No correlation between serum CRP and intraplaque biomarkers was observed. In upstream portions, CRP content was directly correlated with intraplaque neutrophils, total macrophages, and M1 macrophages and inversely correlated with SMC content. In downstream portions, intraplaque CRP correlated with M1 and M2 macrophages. According to the cut-off point (CRP > 2.9%) identified by ROC analysis in upstream portions, Kaplan-Meier analysis showed that patients with high CRP levels had a greater rate of MACEs. This risk of MACEs increased independently of age, male gender, serum CRP, and statin use. In conclusion, in patients with severe carotid artery stenosis, high CRP levels within upstream portions of carotid plaques directly and positively correlate with intraplaque inflammatory cells and predict MACEs at an 18-month follow-up period.

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Section: Discussioncontrasting

confidence: 91%

Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

Bonaventura

Mach

Roth

et al. 2016

Mediators of Inflammation

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“…Bilateral carotid duplex sonography (ACUSON X300, Siemens, Germany) was used to evaluate the presence of carotid stenosis and carotid plaques 1, 12. The investigators were blinded to the clinical and laboratory examination results of the study participants.…”

Section: Methodsmentioning

confidence: 99%

“…A carotid plaque was defined as a focal structure either invading >0.5 mm into the arterial lumen, or invading into at least 50% of the surrounding IMT, or with a thickness at least 1.5 mm from the intimae‐lumen interface to the media adventitia interface. Carotid stenosis was assessed using established ultrasound criteria as follows1: (a) an internal carotid artery peak systolic velocity ≤125 cm/s was defined as <50% stenosis; (b) an internal carotid artery peak systolic velocity 125‐230 cm/s and a visible plaque was defined as 50%‐69% stenosis and (c) an internal carotid artery peak systolic velocity >230 cm/s or a markedly narrowed lumen was defined as >70% stenosis. The carotid ultrasound examination results were reviewed by two independent reviewers.…”

Section: Methodsmentioning

confidence: 99%

“…Carotid atherosclerosis is a primary cause of stroke and disability worldwide 1, 2. Inflammation is an important predictor of carotid atherosclerosis and plays a critical role in the formation and development of plaques and enhancement of the intima media thickness (IMT) 3.…”

Section: Introductionmentioning

confidence: 99%

“…Carotid atherosclerosis is a primary cause of stroke and disability worldwide. 1,2 Inflammation is an important predictor of carotid atherosclerosis and plays a critical role in the formation and development of plaques and enhancement of the intima media thickness (IMT). 3 Many inflammatory biomarkers, including lipoprotein-associated phospholipase A2 (Lp-PLA2), fibrinogen, serum amyloid A (SAA) and interleukin-6 (IL-6), have been approved by the United States Food and Drug Administration (FDA) as predictors of ischemic stroke; additionally, high-sensitivity C-reactive protein (hs-CRP) has been associated with carotid atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

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Association between high‐sensitivity C‐reactive protein, lipoprotein‐associated phospholipase A2 and carotid atherosclerosis: A cross‐sectional study

Liu

Yao

Wang

et al. 2018

J Cellular Molecular Medi

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High‐sensitivity C‐reactive protein (hs‐CRP) and lipoprotein‐associated phospholipase A2 (Lp‐PLA2) have been reported to be independent predictors of atherosclerosis. However, whether the combination of these two markers can improve the prediction of atherosclerosis is unknown. This study aimed to evaluate the association between combining hs‐CRP and Lp‐PLA2 and predicting carotid atherosclerosis. A total of 1982 participants aged ≥40 years were included in this study. Hs‐CRP and Lp‐PLA2 were measured by a high‐sensitivity nephelometry assay and quantitative sandwich enzyme‐linked immunosorbent assay, respectively. Ultrasonography was performed on the bilateral carotid arteries to evaluate stenosis and plaques. Multivariable logistic regression models were used to analyse the association between the combination of the hs‐CRP and Lp‐PLA2 levels and carotid plaques and stenosis. A total of 1579 (79.7%) and 181 (9.1%) subjects had carotid plaques and carotid stenosis, respectively. The group with high hs‐CRP and Lp‐PLA2 levels had the highest prevalence of carotid plaques (90.6%) and stenosis (20.8%). A significant association was found between high hs‐CRP and Lp‐PLA2 levels and carotid stenosis (adjusted odds ratio [OR]: 2.39; 95% confidence interval [CI]: 1.13‐5.09), but this combination was not associated with carotid plaques (OR: 2.62, 95% CI: 0.93‐7.38). The results suggested that the combination of hs‐CRP and Lp‐PLA2 were better predictors than either protein alone with regard to carotid atherosclerosis.

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GWAS-Supported CRP Gene Polymorphisms and Functional Outcome of Large Artery Atherosclerotic Stroke in Han Chinese

Zhang

Sun

et al. 2018

Neuromol Med

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Elevated C-reactive protein (CRP) levels increase the risk of poor functional disability in patients with ischemic stroke (IS). This study aimed to investigate the association between CRP gene polymorphisms and 3-month functional disability of large artery atherosclerotic (LAA) stroke in Han Chinese. Patients with first-ever LAA IS were prospectively enrolled in Nanjing Stroke Registry Program between August 2013 and October 2015. Five single-nucleotide polymorphisms (SNPs) (rs876537, rs2794520, rs3093059, rs7553007 and rs11265260) in CRP gene related to CRP levels in Asian by genome-wide association study were genotyped. The functional outcome at 3 months after the index stroke was assessed by the modified Rankin scale. Associations between genotypes and functional outcome of LAA IS were analyzed with logistic regression model. A total of 690 eligible patients (507 males) were evaluated. SNPs rs11265260 (multivariate-adjusted, p = 0.022), rs2794520 (multivariate-adjusted, p = 0.036) and rs3093059 (multivariate-adjusted, p = 0.027) were significantly associated with elevated CRP in acute IS. Two SNPs, rs3093059 (dominant model: adjusted OR 2.49; 95% CI 1.55-4.00; recessive model: adjusted OR 3.67; 95% CI 1.22-11.03) and rs11265260 (dominant model: adjusted OR 2.51; 95% CI 1.56-4.02; recessive model: adjusted OR 4.70; 95% CI 1.63-13.56) independently predicted 3-month poor outcome of first-ever LAA IS, after adjusting for covariates. In addition, haplotype analysis indicated that haplotype GCTGC (adjusted OR 1.76; 95% CI 1.05-2.95; p = 0.031) increased the poor outcome risk. SNPs rs3093059 and rs11265260 in CRP gene may influence the 3-month functional outcome of first-ever LAA IS in Han Chinese.

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Association between high sensitivity C-Reactive protein and prevalence of asymptomatic carotid artery stenosis

Cited by 19 publications

References 40 publications

Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

Association between high‐sensitivity C‐reactive protein, lipoprotein‐associated phospholipase A2 and carotid atherosclerosis: A cross‐sectional study

GWAS-Supported CRP Gene Polymorphisms and Functional Outcome of Large Artery Atherosclerotic Stroke in Han Chinese

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