Elevated levels of C-reactive protein are associated with impaired coronary collateral development
Elevated levels of C-reactive protein are associated with impaired coronary collateral development
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DOI：
10.1111/j.1365-2362.2006.01641.x
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发表时间：
2006-06-01
影响因子：
5.5
通讯作者：
Erol, C
中科院分区：
文献类型：
--
作者：
Gulec, S;Ozdemir, AO;Erol, C
体外研究表明，c反应蛋白（CRP）减弱一氧化氮的产生并抑制血管生成，这可能导致侧枝发育受损。本研究的目的是探讨高敏CRP （hsCRP）水平与冠状动脉侧枝的范围之间的关系。材料和方法我们根据Rentrop分类研究了185名血管造影显示有高度冠状动脉狭窄或闭塞的患者的hsCRP水平与冠状动脉侧枝范围的关系。结果平均年龄62岁，男性占80%。支脉等级较高的受试者患糖尿病（OR; 0.48, 95%， CI; 0.28, 0.83）或急性冠状动脉综合征（OR; 0.58, 95%， CI; 0.33, 0.99）的可能性较低，但他们更有可能有较多的血管明显狭窄（OR; 1.41, 95%， CI; 1.03, 1.93）和接受他汀类药物治疗（OR; 1.84, 1.09, 3.13）。随着Rentrop分级的增加，平均hsCRP值显著降低（趋势，P = 0.0006）。在调整了年龄、性别、他汀类药物的使用、急性冠状动脉综合征的临床表现、糖尿病和明显狭窄血管的数量后，hsCRP值每增加10个单位对应于侧支评分较高的几率降低31% （OR: 0.69, 95%, CI: 0.53, 0.90）。结论：我们的研究结果表明，hsCRP水平升高与冠状动脉侧支的显著损害有关。这些数据提示了一种以前未被认识到的机制，即炎症可能会使心血管疾病恶化。
Backround In vitro studies have shown that C-reactive protein (CRP) attenuates nitric oxide production and inhibits angiogenesis, which may result in impaired collateral development. The aim of this study was to investigate the association between high sensitivity CRP (hsCRP) levels and the extent of coronary collaterals.Materials ans methods We investigated the association between hsCRP levels and the extent of coronary collaterals according to the Rentrop classification in a cohort of 185 patients who had high-grade coronary stenosis or occlusion on their angiograms.Results Mean age was 62 years and 80% were males. Subjects with a higher grade of collaterals were significantly less likely to have diabetes mellitus (OR; 0.48, 95% and CI; 0.28, 0.83) or acute coronary syndrome (OR; 0.58, 95% and CI; 0.33, 0.99), but they were more likely to have higher number of vessels with significant stenosis (OR; 1.41, 95% and CI; 1.03, 1.93) and to have received statins (OR; 1.84, 1.09, 3.13). The mean hsCRP values reduced significantly as the Rentrop grades increased (trend, P = 0.0006). After adjusting for age, gender, statin use, clinical presentation with acute coronary syndrome, diabetes mellitus and the number of vessels with significant stenosis, each 10-unit increase in hsCRP values corresponded to a 31% reduced odds of having a higher collateral score (OR; 0.69, 95% and CI; 0.53, 0.90).Conclusions Our findings indicate that elevated hsCRP levels are associated with a significant impairment in coronary collateralization. These data suggest a previously unrecognized mechanism through which inflammation may worsen cardiovascular outcomes.