Department of Cardiovascular Rehabilitation, Don Gnocchi Foundation, Florence, Italy.
Nutr Metab Cardiovasc Dis. 2011 Oct;21(10):776-82. doi: 10.1016/j.numecd.2010.02.003. Epub 2010 May 31.
Previous studies have shown that increased levels of C-reactive protein (CRP) predict cardiovascular events, including stroke, myocardial infarction and death from cardiovascular causes. Previous studies have also shown that increased levels of CRP are strong predictors of the progression of pre-existing carotid artery plaques. However, whether CRP is involved in the development of new plaques, that may or may not be associated with clinical events, in subjects with clean carotid arteries has been scarcely investigated.
486 "InCHIANTI" Study participants (200 men and 286 women, 72% aged 65 years and over) free from carotid artery plaques at baseline, also underwent carotid artery scan three years later. We tested the association of baseline characteristics, cardiovascular risk factors and inflammatory markers with the development of new carotid artery plaques. Older participants were significantly more likely to develop new plaques. Independent of age, the relative risks of developing new plaques associated with heavy smoking and family history of atherosclerosis were 1.7 (95%CI 1.5-1.9) and 1.9 (95%CI 1.2-3.1), respectively. Participants with high (>3 μg/mL) and moderate (≥1 and ≤3 μg/mL) CRP levels had a relative risk of 2.2 (95%CI 1.9-2.6) and 1.9 (95%CI 1.6-2.3) respectively, when compared with subjects with low (<1 μg/mL) CRP levels. Surprisingly, risk factors such as hypertension, diabetes, dyslipidemia and overweight/obesity were not significant predictors of the development of new carotid artery plaques.
High CRP levels independently predict the development of new plaques in older persons with carotid arteries free from atherosclerotic lesions.
既往研究表明，C 反应蛋白（CRP）水平升高可预测心血管事件，包括卒中和心肌梗死以及心血管原因导致的死亡。既往研究还表明，CRP 水平升高是颈动脉斑块进展的强有力预测指标。然而，CRP 是否参与无颈动脉粥样硬化病变的受试者中新斑块的形成，以及这些斑块是否与临床事件相关，这方面的研究还很少。
486 名“IN-CHIANTI”研究参与者（200 名男性和 286 名女性，72%年龄≥65 岁）基线时无颈动脉斑块，同时在 3 年后再次接受颈动脉扫描。我们检测了基线特征、心血管危险因素和炎症标志物与新发颈动脉斑块之间的关系。年龄较大的参与者更有可能发生新的斑块。与年龄独立相关的，与重度吸烟和动脉粥样硬化家族史相关的发生新斑块的相对风险分别为 1.7（95%CI 1.5-1.9）和 1.9（95%CI 1.2-3.1）。与 CRP 水平较低（<1μg/mL）的患者相比，CRP 水平较高（>3μg/mL）和中度升高（≥1 且≤3μg/mL）的患者发生新斑块的相对风险分别为 2.2（95%CI 1.9-2.6）和 1.9（95%CI 1.6-2.3）。令人惊讶的是，高血压、糖尿病、血脂异常和超重/肥胖等危险因素并不是新发颈动脉斑块的显著预测因素。
CRP 水平升高可独立预测无颈动脉粥样硬化病变的老年患者中新斑块的形成。
