doi: 10.1161/hc2601.091705
(Circulation. 2001;104:63.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
C-Reactive Protein Is an Independent Predictor of the Rate of Increase in Early Carotid Atherosclerosis
From the Department of Internal Medicine and Therapeutics (A8) (H. Hashimoto, K.K., H. Hougaku, Y.S., M.S., Y.N., M.M., M.H.), and Department of Diagnostic Medicine (S.I., H.Y.), Osaka University Graduate School of Medicine, Osaka, Japan.
Correspondence to Drs Hiroyuki Hashimoto and Masayasu Matsumoto, Division of Strokology, Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail brain{at}medone.med.osaka-u.ac.jp
Background—An elevated plasma concentration of high-sensitivity C-reactive protein (hs-CRP) is a strong predictor of cardiovascular events. However, there have been no longitudinal studies of the relations between development of atherosclerotic lesions and hs-CRP concentrations. Furthermore, it remains unknown whether increased hs-CRP concentrations result in the development of atherosclerosis.
Methods and Results—The
study included 179 outpatients 40 to 79 years of age who were treated
at our institute for traditional risk factors for
cardiovascular disease. The patients had no evidence of
advanced carotid atherosclerosis at the time of
baseline examination. Patients underwent repeated ultrasonographic
evaluation of the carotid arteries for 35±10 months. Blood samples
were collected for hs-CRP measurements. Based on focal intima-media
thickening 
1.1 mm representing plaque, plaque number
(PN) and plaque score (PS; the sum of all plaque thicknesses) were
calculated. The development of atherosclerosis was
estimated by the formula 
value/year=(last value-baseline
value)/number of follow-up years. Multivariate linear
regression analysis revealed that the log-transformed value for
hs-CRP concentration was not related to baseline PN or PS but was
related to PN/year and PS/year (ß=0.29 and 0.30;
P<0.001 for both)
independently of the effect of traditional risk
factors.
Conclusions—During the early stages of carotid atherosclerosis, the hs-CRP concentration is a marker of carotid atherosclerotic activity rather than extent of atherosclerosis.
Key Words: C-reactive protein • atherosclerosis • inflammation • ultrasononics • carotid arteries
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