Division of Cardiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Tokyo, Japan.
J Atheroscler Thromb. 2010 May;17(5):460-7. doi: 10.5551/jat.2931. Epub 2010 Feb 5.
Limited correlations between C-reactive protein (CRP) and coronary artery disease (CAD) have been reported. Recently, MRI became a useful tool for non-invasively evaluating atherosclerotic plaques in thoracic and abdominal aortas.
To elucidate the associations between plasma CRP levels and the severities of coronary and aortic atherosclerosis, we performed aortic black-blood MRI in 136 patients undergoing coronary angiography. For each patient, 9 slices of thoracic aorta and 9 slices of abdominal aorta were obtained at 12-mm intervals, and the plaque extent in each slice was scored. The degree of aortic atherosclerosis is represented as the sum of scores. The degree of coronary atherosclerosis is represented as the number of >50% stenotic vessels and >25% stenotic segments.
CAD (>50% stenosis) was present in 96 patients. Patients with CAD had higher CRP levels than those without CAD (median 0.78 vs. 0.48 mg/L, p<0.02). CRP levels tended to increase depending on the number of stenotic vessels: 0.48, 0.70, 0.74, and 0.88 mg/L (p=NS). CRP correlated weakly with the number of stenotic segments (r=0.21). Regarding aortic atherosclerosis, 136 patients were divided into quartiles by plaque score. CRP levels increased stepwise in quartiles: 0.40, 0.56, 1.08, and 1.10 mg/L (p<0.001). CRP levels also correlated with the plaque score (r=0.38). In multivariate analysis, aortic atherosclerosis was an independent factor for CRP levels, but coronary atherosclerosis was not.
Plasma CRP levels correlated with the severities of both coronary and aortic atherosclerosis, but CRP levels are more likely to reflect the severity of aortic atherosclerosis than coronary atherosclerosis.
已有研究报道 C 反应蛋白（CRP）与冠状动脉疾病（CAD）之间相关性有限。近来，磁共振成像（MRI）已成为一种评估胸腹部主动脉粥样硬化斑块的有用工具。
为了阐明血浆 CRP 水平与冠状动脉和主动脉粥样硬化严重程度之间的相关性，我们对 136 例行冠状动脉造影的患者进行了主动脉黑血 MRI 检查。对每位患者，在 12mm 间隔处获得 9 个胸主动脉切片和 9 个腹主动脉切片，并对每个切片的斑块程度进行评分。主动脉粥样硬化程度以评分总和表示。冠状动脉粥样硬化程度以狭窄>50%的血管数和狭窄>25%的节段数表示。
96 例患者存在 CAD（狭窄>50%）。CAD 患者的 CRP 水平高于无 CAD 患者（中位数 0.78 比 0.48mg/L，p<0.02）。CRP 水平随狭窄血管数的增加而升高：0.48、0.70、0.74 和 0.88mg/L（p=NS）。CRP 与狭窄节段数的相关性较弱（r=0.21）。关于主动脉粥样硬化，136 例患者按斑块评分分为四分位组。CRP 水平呈阶梯式升高：0.40、0.56、1.08 和 1.10mg/L（p<0.001）。CRP 水平也与斑块评分相关（r=0.38）。多变量分析显示，主动脉粥样硬化是 CRP 水平的独立影响因素，但冠状动脉粥样硬化不是。
血浆 CRP 水平与冠状动脉和主动脉粥样硬化的严重程度相关，但 CRP 水平更可能反映主动脉粥样硬化的严重程度，而非冠状动脉粥样硬化。
