Department of Neurology, Division of Cerebrovascular Diseases, Michigan State University/Sparrow Health System, East Lansing, MI, USA.
J Neuroimaging. 2010 Jan;20(1):74-7. doi: 10.1111/j.1552-6569.2008.00313.x. Epub 2008 Oct 21.
High-sensitivity C-reactive protein (hsCRP) is an inflammatory marker associated with subsequent coronary events and neointimal hyperplasia after coronary artery stent placement. We sought to determine if elevated levels of hsCRP are associated with restenosis after placement of extra- and intracranial stents.
We retrospectively reviewed 73 consecutive patients at Michigan State University from July 2006 until June 2007 who underwent treatment with carotid artery stent placement or intracranial stent placement. Data were collected in regards to demographics, pre-procedural hsCRP, and LDL levels, and angiographic variables characterizing the lesion before and after treatment. A binary logistic regression model was constructed to determine independent predictors of restenosis.
A total of 73 patients with a mean age of 69 +/- 11 years were studied. A total of 57 patients were treated with extracranial carotid stenting, 22 (38%) of whom were symptomatic, while 16 patients underwent intracranial stenting (all were symptomatic). There were 9 patients (4 intracranial stents [25%] and 5 carotid stents [8.8%]) who developed a restenosis of >50%. In binary logistic regression modeling, the following variables were found to be independently predictive of developing restenosis: smaller vessel diameter (OR .49, 95% CI .23-.98, P-value .046) and elevated hsCRP (OR 2.2, 95% CI 1.29-6.66, P-value .018).
Elevated levels of pre-procedural hsCRP may be predictive of the development of neointimal hyperplasia in patients treated with extra- or intracranial stenting procedures. Future prospective multicenter studies will be required to confirm these findings.
高敏 C 反应蛋白（hsCRP）是一种与随后的冠状动脉事件和冠状动脉支架放置后新生内膜增生相关的炎症标志物。我们试图确定 hsCRP 水平升高是否与颅内外支架放置后的再狭窄有关。
我们回顾性分析了 2006 年 7 月至 2007 年 6 月期间在密歇根州立大学接受颈动脉支架置入术或颅内支架置入术治疗的 73 例连续患者。收集的数据包括人口统计学资料、hsCRP 和 LDL 水平的术前值，以及治疗前后病变的血管造影变量。构建二项逻辑回归模型以确定再狭窄的独立预测因素。
共研究了 73 例平均年龄 69 ± 11 岁的患者。57 例患者接受了颅外颈动脉支架置入术，其中 22 例（38%）为症状性，16 例接受了颅内支架置入术（均为症状性）。有 9 例患者（4 例颅内支架[25%]和 5 例颈动脉支架[8.8%]）发生了>50%的再狭窄。在二项逻辑回归模型中，以下变量被发现是发生再狭窄的独立预测因素：血管直径较小（OR.49，95%CI.23-.98，P 值.046）和 hsCRP 升高（OR 2.2，95%CI 1.29-6.66，P 值.018）。
术前 hsCRP 水平升高可能是预测颅内外支架置入术患者新生内膜增生的指标。需要进行未来的多中心前瞻性研究来证实这些发现。
