Markers of inflammation and infection influence the outcome of patients with baseline asymptomatic carotid lesions - A 5-year follow-up study
Markers of inflammation and infection influence the outcome of patients with baseline asymptomatic carotid lesions - A 5-year follow-up study
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DOI：
10.1161/01.str.0000198813.56398.14
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发表时间：
2006-02-01
期刊：
影响因子：
8.3
通讯作者：
Novo, S
中科院分区：
文献类型：
--
作者：
Corrado, E;Rizzo, M;Novo, S
背景和目的-它仍然是在辩论中的感染和炎症的标志物的评价是否可能是重要的脑血管和心血管的预防，我们的目的是调查这一领域在一个前瞻性的5年临床随访研究患者的早期阶段atherosclerosis.Methods -我们研究了668名受试者分为3组，根据颈动脉超声检查的结果：（1）正常受试者，如果内膜中层厚度（IMT）为1.5 mm。研究传统的心血管危险因素，实验室分析包括测量血脂、纤维蛋白原、C反应蛋白、幽门螺杆菌（HP）、细胞毒性HP、巨细胞病毒和肺炎衣原体的IgG抗体。在多变量分析中我们发现高水平的纤维蛋白原（P < 0.0001）和C反应蛋白（P = 0.014），对细胞毒性HP的血清阳性率（P = 0.001）和肺炎衣原体（P = 0.026），存在IMT或无症状颈动脉斑块（P < 0.0001），感染总负担（P < 0.0001）是预测临床事件的变量。结论-除了传统的心血管危险因素外，炎症和感染标志物似乎显著影响基线无症状颈动脉病变患者的脑血管和心血管事件的发生。
Background and Purpose - It is still in debate whether the evaluation of markers of infection and inflammation may be of importance for cerebrovascular and cardiovascular prevention, and we aimed to investigate this field in a prospective 5-year clinical follow-up study in patients with early stages of atherosclerosis.Methods - We studied 668 subjects divided in 3 groups according to the results of carotid ultrasound examination: (1) normal subjects, if intima-media thickness (IMT) was 1.5 mm. Traditional cardiovascular risk factors were investigated, and laboratory analysis included measurement of plasma lipids, fibrinogen, C-reactive protein, IgG antibodies for helicobacter pylori (HP), cytotoxic HP, cytomegalovirus, and chlamydia pneumoniae.Results - Cerebrovascular or cardiovascular events were registered in 18% of patients during the follow-up, and at multivariate analysis we found that the high levels of fibrinogen (P < 0.0001) and C-reactive protein (P = 0.014), the seropositivity to cytotoxic HP (P = 0.001) and chlamydia pneumoniae (P = 0.026), the presence of IMT or asymptomatic carotid plaque (P < 0.0001), and the total burden of infections (P < 0.0001) were the variables predictive of the clinical events.Conclusions - Beyond traditional cardiovascular risk factors, markers of inflammation and infections seem to significantly influence the occurrence of cerebrovascular and cardiovascular events in patients with baseline asymptomatic carotid lesions.