Is the level of C-reactive protein correlated with the extent of carotid atherosclerosis?

BACKGROUND

Increased intima-media thickness (IMT) of the common carotid arteries (CCA) and elevated levels of highly sensitive C-reactive protein (hsCRP) are both shown to be associated with the occurrence of stroke. We investigated whether elevated hsCRP level is a risk factor for the increased IMT of the CCA independent of other proven risk factors for the ischemic stroke and studied the interaction between hsCRP level and the extent of carotid atherosclerosis.

METHODS AND RESULTS

We studied 104 patients aged between 30 to 92 years who were admitted to our neurology department with acute ischemic stroke. All patients underwent a clinical evaluation, laboratory investigations, and neuroultrasonographic examination. In 24 patients with normal ultrasonographic examination, mean hsCRP levels was 8.6 + 6.7 mg/L. Mean hsCRP level was 18.0 + 25.6 mg/L in patients having increased intima to media thickness (> 1.2 mm); 32.7 + 49.1 mg/L in patients who had atheromatous plaques without significant narrowing; and 23.9 + 27.3 mg/L in patients with internal carotid artery stenosis more than 50%. hsCRP levels and the extent of the atherosclerosis showed a significant relationship (p = 0.040). In multiple regression analyses, this relationship was found to be independent of other proven risk factors. The only variable that showed a significant relation with the level of hsCRP was the HDL level. A negative correlation was found between hsCRP and HDL levels.

CONCLUSIONS

We conclude that elevated hsCRP level is an indirect risk factor for the ischemic stroke through its relation with the extent of the carotid atherosclerosis, and this relation is independent of other known risk factors.