No Association Between High-Sensitivity C-Reactive Protein and Carotid Intima-Media Progression: The APAC Study

Wang, Anxin; Huang, Xiaoya; Liu, Xiaoxue; Su, Zhaoping; Wu, Jianwei; Chen, Shuohua; Liu, Xuemei; Ruan, Chunyu; Guo, Xiuhua; Wu, Shouling; Wang, Wenjuan

doi:10.1016/j.jstrokecerebrovasdis.2016.09.013

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…Furthermore, a reported large series found no significant association between the progression of cIMT and average hsCRP levels over a 2-year period; values were also not related in a dose-response manner. 49 Indeed, serum hs-CRP, as an indicator of a chronic inflammatory state, is not organ-specific and displays a lognormal distribution throughout different study populations, which makes it difficult to obtain a threshold or diagnostic cutpoint for a specific disease. Additionally, CRP is closely linked to various factors, including blood pressure, age, sex, diabetes, smoking, LDL-C, HDL-C, ventricular hypertrophy, and atrial fibrillation, 50 which limits its effectiveness as a marker for disease risk stratification.…”

Section: Discussionmentioning

confidence: 99%

Homocysteine Combined with Apolipoprotein B as Serum Biomarkers for Predicting Carotid Atherosclerosis in the Oldest-Old

Liu,

Li,

Cheng

et al. 2023

CIA

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Background The measurement of serum biomarkers is a promising decision aid in the assessment of atherosclerosis. However, data on the levels and epidemiological distribution of serum biomarkers of carotid atherosclerosis (CAS) in the oldest-old are limited. This study aimed to investigate the characteristics of CAS serum biomarkers in the oldest-old over 80 and explore their predictive value for CAS. Methods As part of the China Hainan Centenarian Cohort Study, a total of 1565 individuals over 80 years old were included. Atherosclerosis was assessed by carotid plaque and carotid intima-media thickness. Serum biomarker levels, demographic indicators, and physical examination indicators were detected. Prediction factors correlated to the CAS were explored by logistic regression and verified by receiver operating characteristic curve analysis. Multivariate regression models were fitted, along with subgroup analysis and robustness tests. Results Among the oldest-old population, 83.5% (1306) had CAS. In a fully adjusted multivariate logistic regression model, systolic blood pressure (SBP), heart rhythm (HR), serum homocysteine (Hcy), and apolipoprotein B (ApoB) levels were significantly and positively associated with CAS in the oldest-old (P S < 0.001). ROC analysis indicated that the combination of serum Hcy, ApoB, SBP, and HR increased the predictive value for CAS in the oldest-old (area under the curve: 0.856, 95% CI: 0.803–0.879; sensitivity: 81.8%; specificity: 85.9%). Conclusion SBP, HR, Hcy and ApoB are independent risk factors for CAS in the oldest-old. The specific set of biomarkers and their combination with other risk markers may be a promising strategy for assessing CAS in the elderly, especially in global aging.

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Section: Discussionmentioning

confidence: 99%

Homocysteine Combined with Apolipoprotein B as Serum Biomarkers for Predicting Carotid Atherosclerosis in the Oldest-Old

Liu,

Li,

Cheng

et al. 2023

CIA

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“…Another limitation might be that we did not assess hs-CRP influence on carotid intima-media progression. 46 However, the main focus of the study was on inflammatory markers' influence on intimal hyperplasia overgrowth as a cause of CR more than on new atherosclerotic lesions, especially having in mind that hs-CRP showed no association with carotid intima-media progression. 46 Increased hs-CRP might be correlated to plaque vulnerability in patients undergoing carotid revascularization.…”

Section: Discussionmentioning

confidence: 99%

“…46 However, the main focus of the study was on inflammatory markers' influence on intimal hyperplasia overgrowth as a cause of CR more than on new atherosclerotic lesions, especially having in mind that hs-CRP showed no association with carotid intima-media progression. 46 Increased hs-CRP might be correlated to plaque vulnerability in patients undergoing carotid revascularization. 47 The main goal of the study was to identify factors influencing recurrent stenosis after CEA, and therefore hs-CRP was not evaluated in terms of plaque vulnerability before CEA; still, we have shown that vulnerable plaque had no influence on CR during follow-up.…”

Section: Discussionmentioning

confidence: 99%

Scoring system to predict early carotid restenosis after eversion endarterectomy by analysis of inflammatory markers

Tanasković

Radak

Aleksić

et al. 2018

Journal of Vascular Surgery

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“…hs-CRP may predict plaque instability on MR imaging (hypointensity in T1 weighted images) (Shindo et al 2014) and levels 5 mg/L or greater were significantly associated with a greater number of new cerebral lesions detected on diffusion weighted MR imaging during carotid artery stenting (Pini et al 2013), but did not correlate with plaque inflammation as determined by carotid artery fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) (Duivenvoorden et al 2013;Rudd et al 2009). A recently reported large series found no significant association between progression of carotid intima-media thickness (cIMT) over a 2-year period and average hsCRP levels; values were also not related in a doseresponse manner, assuming it might be considered as risk marker rather than a causal factor (Wang et al 2017). Nevertheless, elevated baseline hs-CRP levels were independently associated with increased ischemic stroke risk in a meta-analysis summarizing results of 12 studies, which included more than 2000 patients (Zhou et al 2016) and also predicted early restenosis after carotid endarterectomy (Tanaskovic et al 2018).…”

Section: Complement Reactive Protein and Pentraxin-3mentioning

confidence: 98%

The cellular biology of atherosclerosis with atherosclerotic lesion classification and biomarkers

Melaku

Dabi

2021

Bull Natl Res Cent

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Background Atherosclerosis is a chronic lipid-driven inflammatory disease with infiltration of low-density lipoprotein and is considered as the pivotal step in plaque formation. The aim of the review is to get into the fine details of pathophysiologic mechanisms responsible for atherosclerosis with atherosclerotic lesion classification. It also provides a summary of current biomarkers other than the traditional risk factors so that new treatment modalities can emerge and reduce the morbidity and mortality associated with atherosclerosis. Main body In the classification of atherosclerosis made by American Heart Association (AHA), AHA Type I lesion is the earliest vascular change described microscopically. AHA Type II lesion is primarily composed of abundant macrophages. AHA Type III lesion is the earliest of progressive lesions, while AHA Type IV lesion consists of an acellular necrotic core. Various biomarkers are implicated in different stages of the pathophysiological mechanism of plaque formation and evolution. C Reactive Protein plays a direct role in promoting the inflammatory component of atherosclerosis. Fibrinogen was demonstrated to be elevated among patients with acute thrombosis. Higher leukocyte count is associated with a greater cardiovascular risk. Cytokines have been implicated in atheroma formation and complications. High rates of protease activated receptor expression are also induced by interleukin-6 secretion in atherosclerotic lesions and areas of vascular tissue injury. Cluster of differentiation 40 receptor and its ligand have been also detected in atherosclerotic plaques. Osteopontin, acidic phosphoprotein, and osteoprotegerin have emerged as novel markers of atherosclerotic plaque composition. There are also overproductions of matrix metalloproteinases in the rupture-prone regions and promote lipid-necrotic core formation in the atherosclerotic plaque. Myeloperoxidase has been proposed as a marker of plaque instability. Oxidized low-density lipoprotein receptor 1 provides a route of entry for oxidized low-density lipoprotein into the endothelium. A human atherosclerotic lesion also expresses lipoprotein-associated phospholipase A2. Short conclusion Atherosclerotic plaques are the battlefield between an unbalanced immune response and lipid accumulation in the intima of arteries. Most of the biomarkers associated with atherosclerosis are indicators of inflammatory response and will also be used for medical purposes.

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No Association Between High-Sensitivity C-Reactive Protein and Carotid Intima-Media Progression: The APAC Study

Cited by 9 publications

References 33 publications

Homocysteine Combined with Apolipoprotein B as Serum Biomarkers for Predicting Carotid Atherosclerosis in the Oldest-Old

Homocysteine Combined with Apolipoprotein B as Serum Biomarkers for Predicting Carotid Atherosclerosis in the Oldest-Old

Scoring system to predict early carotid restenosis after eversion endarterectomy by analysis of inflammatory markers

The cellular biology of atherosclerosis with atherosclerotic lesion classification and biomarkers

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