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hsCRP levels combined with the extent of carotid atherosclerosis provide additional prognostic information

Mayer FJ et al., Stroke. 2016

Combined Effects of Inflammatory Status and Carotid Atherosclerosis: A 12-Year Follow-Up Study


Mayer FJ, Binder CJ, Wagner OF, et al.
Stroke. 2016;47:2952-2958
 

Background

Inflammation plays a substantial role in atherogenesis, and elevated pro-inflammatory responses promote plaque progression and its vulnerability to rupture [1]. Several inflammatory biomarkers predictive of CV outcomes in patients with atherosclerotic diseases have been identified, but the only circulatory biomarker frequently used for CV risk assessment in current clinical practice is hsCRP (high-sensitivity C-reactive protein) [2,3]. Serum levels of hsCRP are associated with morphological features of carotid atherosclerosis, progression of carotid narrowing and short-term CV events, and represents an important risk factor for the development and progression of carotid atherosclerosis [4,5]. However, no study has investigated whether, or to what extent, hsCRP might be predictive of mortality in patients with carotid stenosis.
In this study, the prognostic value of hsCRP for cause-specific mortality was evaluated, in a large prospective cohort of patients with asymptomatic carotid atherosclerosis. It was further hypothesised that the degree of carotid narrowing and the levels of hsCRP jointly contribute to the CV risk in these patients.
 

Main results

 

Conclusion

In a large prospective cohort of patients with asymptomatic carotid atherosclerosis, there was a significant association between hsCRP levels and long-term mortality. Moreover, the combination of the extent of carotid atherosclerosis and inflammatory status provides additional prognostic information for these patients.
 
Find this article online at Stroke
 

References

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2. Schillinger M, Exner M, Amighi J, et al. Joint effects of C-reactive protein and glycated haemoglobin in predicting future cardiovascular events of patients with advanced atherosclerosis. Circulation. 2003;108:2323–2328.
3. Ridker PM, Cushman M, Stampfer MJ, et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973–979.
4. Schillinger M, Exner M, Mlekusch W, et al. Inflammation and Carotid Artery–Risk for Atherosclerosis Study (ICARAS). Circulation. 2005;111:2203–2209.
5. Schlager O, Exner M, Mlekusch W, et al. C-reactive protein predicts future cardiovascular events in patients with carotid stenosis. Stroke. 2007;38:1263–1268.