Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease

Fichtlscherer, Stephan; Rosenberger, Gunter; Walter, Dirk; Breuer, Susanne; Dimmeler, Stefanie; Zeiher, Andreas M.

doi:10.1161/01.cir.102.9.1000

Cited by 611 publications

(416 citation statements)

References 22 publications

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“…Elevated CRP is also associated with endothelial dysfunction [40]. Saito et al [41] suggested that variations in circulating hsCRP, even within the normal range is involved in the interrelation of cardiovascular risk factors, like age, smoking, obesity, high blood pressure and dyslipidemia, which are supposed to promote atherosclerosis and ultimately provoke cardiovascular diseases, such as coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Jalali

Phadke

2011

Ind J Clin Biochem

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Conditions like hypertension, atherosclerosis and diabetes are known to be the result of endothelial dysfunction which could begin early in the life of an individual. The markers of endothelial dysfunction studied in the present work are plasma hemoglobin, serum high sensitivity C-reactive protein (hsCRP) and plasma nitrite and nitrate. We studied the onset of endothelial dysfunction with increase in age as well as in disease condition like newly detected hypertensives and of hypertensive diabetic patients. The mean plasma hemoglobin and hsCRP values were found to increase with age. hsCRP and plasma hemoglobin levels were significantly higher in patient groups as compared to aged-matched controls. On the other hand nitrate and nitrite was significantly higher in patients who suffered from both diabetes and hypertension together and nitrate values were significantly lower in patients who suffered from hypertensive alone. Plasma hemoglobin and hsCRP are associated with endothelial dysfunction and increases both with age as well as in disease condition.

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Section: Discussionmentioning

confidence: 99%

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Jalali

Phadke

2011

Ind J Clin Biochem

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“…6,7,16 Fichtlscherer et al indicated that elevated serum CRP levels indicative of a systemic inflammatory response reflected a blunted systemic endothelial function, and normalization of CRP levels over time was associated with a significant improvement in endothelium-mediated blood flow responses. 8 This implies elevated CRP levels as an independent risk factor for endothelial dysfunction might provide an important clue to link a systemic inflammation to atherosclerotic disease progression. The possible mechanism for addition of hsCRP to endothelial function increased the predict power of cardiovascular event may be related to atherosclerosis induced by vascular inflammation and endothelium injury in different ways.…”

Section: Endothelial Function Inflammatory Marker Of Hscrp and Athementioning

confidence: 99%

“…4,5 C-reactive protein (CRP), a marker of inflammation, has been demonstrated to be predictive of cardiovascular morbidity and mortality. 6,7 One study indicated that elevated serum CRP levels is associated with a blunted endothelial vasodilator function, 8 suggesting an important clue to link a systemic marker of inflammation to atherosclerotic disease progression. However, limited data were available to determine whether the combination of these two crucial factors of atherosclerosis could have additive power in predicting cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Combined use of endothelial function assessed by brachial ultrasound and high‐sensitive C‐reactive protein in predicting cardiovascular events

Huang

Chen

et al. 2007

Clinical Cardiology

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SummaryBackground: Endothelial function plays a key role in determining the clinical manifestations of atherosclerotic lesions. Elevated high-sensitive C-reactive protein (hsCRP) relates to long-term prognosis of cardiovascular disease.Hypothesis: We test the hypothesis that combined use of endothelial function and hsCRP could increase predictive value of future cardiovascular events.Methods and Results: 205 patients were followed up for a median period of 24 months. Endothelial function was assessed using brachial ultrasound to measure endothelium-dependent flow-mediated vasodilation (FMD). Cox regression analyses were conducted for the 205 subjects, with cardiovascular events being defined as myocardial infarction, hospitalization due to congestive heart failure, percutaneous coronary intervention, coronary artery bypass grafting, and ischemic stroke. Twenty nine (14%) developed cardiovascular events. Both FMD and hsCRP were significantly predictive of cardiovascular events (relative risk for patients with FMD < 3% as compared to those with FMD

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“…[18][19][20] However, in the peripheral vasculature, normalization of elevated hsCRP concentrations over time is associated with a normalization of endothelium-mediated flow after 3 months in patients with coronary artery disease. 45 Thus, in the present study dxinduced anti-inflammatory period for 2 days might be too short to improve coronary vascular resistance in obese subjects. On the other hand, it is possible that the role of hsCRP in the blunted vasoreactivity is different between the peripheral and cardiac vasculature indicating the complexity of the regulation of coronary arteries.…”

Section: Discussionmentioning

confidence: 63%

Short-term changes in inflammatory response protein (hsCRP) do not parallel with changes in coronary vasoreactivity in obese men

et al. 2005

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Aim: Obese subjects are characterized by increased high-sensitivity C-reactive protein (hsCRP) and coronary vascular resistance. Clucocorticoids suppress inflammation, a possible cardioprotective effect. We tested the short-term anti-inflammatory effect of dexamethasone (dx) on these parameters in obese subjects. Methods: Coronary vascular resistance was quantitated basally and during adenosine infusion with or without simultaneous euglycemic hyperinsulinemic clamp (insulin infusion rate of 1 mU/kg/min) in 11 obese and 19 age-matched nonobese males using positron emission tomography and 15 O-water. Each subject was studied both with and without previous dx treatment for 2 days (2 mg/day). Results: Before dx treatment, hsCRP concentration was significantly higher in obese than in nonobese subjects (1.5571.73 vs 0.3270.32 mg/l, P ¼ 0.005). In addition, coronary vascular resistances were higher (Po0.05) in obese than in nonobese subjects at baseline (139736 vs 117722) and during adenosine infusion without (3277 vs 2677) or with simultaneous clamp (2678 vs 2175 mmHg min g/ ml). Dx treatment decreased significantly hsCRP concentration in obese but not in nonobese subjects, leading to similar hsCRP concentrations between the groups (0.4570.43 vs 0.2670.42 mg/l, respectively, P ¼ 0.3). Dx had no effect on coronary vascular resistances (NS). Conclusions: Obese subjects are characterized by high hsCRP, which can be normalized by dx. However, despite this, coronary vascular resistances did not decrease in obese subjects. Short-term changes in inflammatory response protein appear not to parallel with changes in coronary vasoreactivity in obese men.

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Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease

Cited by 611 publications

References 22 publications

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Combined use of endothelial function assessed by brachial ultrasound and high‐sensitive C‐reactive protein in predicting cardiovascular events

Short-term changes in inflammatory response protein (hsCRP) do not parallel with changes in coronary vasoreactivity in obese men

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