Inflammation and carotid artery - Risk for atherosclerosis study (ICARAS)
Inflammation and carotid artery - Risk for atherosclerosis study (ICARAS)
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DOI：
10.1161/01.cir.0000163569.97918.c0
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发表时间：
2005-05-03
期刊：
影响因子：
37.8
通讯作者：
Minar, E
中科院分区：
文献类型：
--
作者：
Schillinger, M;Exner, M;Minar, E
背景-令人信服的证据表明，炎症是从根本上参与动脉粥样硬化的发病机制，然而，炎症和动脉粥样硬化进展的形态学特征之间的时间相关性还没有被证明是明确的。方法和结果-我们前瞻性地研究了1268例连续患者谁是最初无症状的颈动脉疾病。患者在基线时和中位随访间隔7.5个月（范围6至9个月）后接受了一系列颈动脉超声检查，测量颈动脉流速并将颈动脉分类为0%至29%、30%至49%、50%至69%、70%至89%或90%至99%狭窄或闭塞。在基线和随访时测定高敏C反应蛋白（hs-CRP）和血清淀粉样蛋白A（SAA）。1268例患者中有103例（8.1%）出现颈动脉粥样硬化进展。基线（P = 0.004和P = 0.014）和随访（P <0.001和P < 0.001）时的Hs-CRP和SAA以及基线至随访的变化（P < 0.001和P < 0.001）与进展性动脉粥样硬化显著相关。随着基线hs-CRP水平五分位数的增加，动脉粥样硬化进展的校正OR（95% CI）为1.65（0.71至3.84）、1.87（0.8至4.37）、3.32（1.49至7.39）和3.65（1.65至8.08），随着基线SAA五分位数的增加，它们为0.86（0.38至1.92），0.99（0.49至1.99）、1.72（0.91至3.28）和2.28（1.24 ~ 4.20），与最低的五分位数相比。结论-这些发现为炎症和快速进展的颈动脉粥样硬化的形态学特征之间的密切时间相关性提供了证据，这表明炎性生物标志物hs-CRP和SAA的升高或增加鉴定了活动性动脉粥样硬化疾病的存在。
Background-Compelling evidence suggests that inflammation is fundamentally involved in the pathogenesis of atherosclerosis; however, temporal correlation between inflammation and morphological features of atherosclerosis progression has not been demonstrated unequivocally.Methods and Results-We prospectively studied 1268 consecutive patients who were initially asymptomatic with respect to carotid artery disease. Patients underwent serial carotid ultrasound investigations at baseline and after a follow-up interval of a median of 7.5 months ( range 6 to 9 months), with measurement of carotid flow velocities and categorization of carotid arteries as 0% to 29%, 30% to 49%, 50% to 69%, 70% to 89%, or 90% to 99% stenosed or occluded. High-sensitivity C-reactive protein (hs-CRP) and serum amyloid A (SAA) were measured at baseline and follow-up. Progression of carotid atherosclerosis was found in 103 (8.1%) of 1268 patients. Hs-CRP and SAA, respectively, at baseline (P = 0.004 and P = 0.014) and follow-up (P < 0.001 and P < 0.001) and the change from baseline to follow-up (P < 0.001 and P < 0.001) were significantly associated with progressive atherosclerosis. Adjusted ORs (95% CI) for atherosclerosis progression with increasing quintiles of baseline hs-CRP were 1.65 (0.71 to 3.84), 1.87 (0.8 to 4.37), 3.32 (1.49 to 7.39), and 3.65 (1.65 to 8.08), and with increasing quintiles of baseline SAA, they were 0.86 (0.38 to 1.92), 0.99 (0.49 to 1.99), 1.72 (0.91 to 3.28), and 2.28 (1.24 to 4.20), respectively, compared with the lowest quintiles.Conclusions-These findings supply evidence for a close temporal correlation between inflammation and morphological features of rapidly progressive carotid atherosclerosis, which suggests that elevation or increase of the inflammatory biomarkers hs-CRP and SAA identifies the presence of active atherosclerotic disease.