An Update on the Role of Markers of Inflammation in Atherosclerosis

Abstract

In recent years, several studies have used the measurement of carotid intima-media thickness (IMT) as a marker of early atherosclerosis: IMT has been shown to correlate significantly with the presence of coronary artery disease (CAD) and to predict fatal and not fatal cerebro-and cardio-vascular events. These findings highlight the importance of recognizing and managing early stages of atherosclerosis for effective cardiovascular prevention. Beyond traditional established cardiovascular risk factors, inflammation has been shown to be crucial throughout atherosclerosis from endothelial dysfunction to plaque rupture and thrombosis. Several studies have shown the existence of a strong relation between CAD and fibrinogen or highly sensitive C-reactive protein (hs-CRP) levels and their predictive role has been examined through stratification or multivariable statistical analyses: levels of these markers of inflammation have been independently associated with the incidence of coronary events after adjusting for traditional cardiovascular risk factors. Recent studies have further addressed the importance of therapeutical modulation of hs-CRP levels in high-risk patients for the prevention of vascular events. The strong relationship between hs-CRP and IMT may potentially account for the complex role of hs-CRP and IMT in the pathogenesis of cardiovascular events. However, beyond the utility of measuring markers of inflammation to assess patients with subclinical carotid atherosclerosis at higher risk of vascular events, further studies are needed to evaluate the therapeutic implications in this category of patients.

Can Carotid Plaque Histology Selectively Predict the Risk of an Acute Coronary Syndrome?

“…Recent observations have suggested that inflammation may also be a possible link between coronary and carotid instability. 21) In our study, instead, the degree of inflammation observed at histology was No inflammation (-) was present in 54% of patients in group A, and in 28% of patients in group B, (P = 0.031). There was no significant difference for subclass "+", while subclass "++" resulted at the limits of statistical significance, a marked inflammatory infiltration being present only in 9% of group A patients, versus 30% of group B patients.…”

“…6,15,16) Moreover, the amount of calcium and the rapid progression of calcification at the coronary arteries level have been associated in previous works with a higher risk of cardiovascular events. [17][18][19][20][21] Therefore, carotid calcifications could reflect diffuse coronary artery disease. Our study demonstrates that the presence of an extensively calcified carotid plaque is strongly suggestive of the likelihood of an acute coronary event or at least a warning sign of advanced coronary artery disease.…”

Adipose Tissue and Serum CCDC80 in Obesity and Its Association with Related Metabolic Disease

“…of visceral adiposity in some studies (33,34) and is known to be closely linked to carotid intima-media thickness (35). In addition, nonalcoholic steatohepatitis can predict a more atherogenic risk profile (34).…”

Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly

“…Two such markers are the inflammatory protein high-sensitive C-reactive protein (hs-CRP), which is related to cardiovascular disease and is stimulated by the proinflammatory cytokine interleukin 6 (IL6) (10), and the N-terminal pro-brain natriuretic peptide (NT-proBNP), used as a diagnostic parameter for congestive heart failure (11). Previous studies on patients with active acromegaly have shown lower than normal values of hs-CRP in most (9,12,13,14,15), but not all studies (16).…”