Dipartimento di Cardiologia Ospedale Civile di Mirano, Università Tor Vergata, Rome, Italy.
Mayo Clin Proc. 2012 Jan;87(1):50-8. doi: 10.1016/j.mayocp.2011.10.002.
To assess whether inflammatory markers predict atherosclerotic disease activity after carotid treatment in patients with severe carotid stenosis and nonsignificant coronary artery disease undergoing carotid stenting.
From March 1, 2004, to September 30, 2005, a total of 55 consecutive patients (mean ± SD age, 69±8.3 years; 26 men) with severe carotid stenosis and nonsignificant coronary artery disease were treated with carotid stent implantation. Patients were followed up for a period of 5 years for the occurrence of cardiovascular events.
A significant correlation between quantitative analysis of debris entrapped in the filters and inflammatory markers was found. Moreover, the number of particles per filter, the total particles area, and the mean particle axis per filter were significantly higher in patients with clinical events at the follow-up compared with patients without events (87 vs 32, P=.006; 50,118.7 vs 17,782, P=.002; 33.9 vs 30.2, P=.03). At 5-year follow-up we recorded cardiovascular or neurologic events in 11 of the 55 patients (20%). Higher preprocedural levels of high-sensitivity C-reactive protein, interleukin 6 soluble receptor, and interleukin 6 were significantly associated with clinical events at follow-up (P<.001, P=.05, and P=.02, respectively). In particular high-sensitivity C-reactive protein measured at 24 and 48 hours after carotid stenting showed a significant correlation with clinical events (P=.001). Also preprocedural intracellular adhesion molecule 1 and circulating vascular cell adhesion molecule 1 blood concentrations were significantly correlated with a worse prognosis at follow-up (P=.04 and P=.03, respectively).
In patients with severe carotid stenosis and nonsignificant coronary artery disease, inflammation is associated with atherosclerotic disease activity and a worse prognosis. Interleukin 6, interleukin 6 soluble receptor, intracellular adhesion molecule 1, vascular cell adhesion molecule 1, and high-sensitivity C-reactive protein levels at baseline and 24 and 48 hours after carotid stenting are predictive of neurologic and cardiovascular events at follow-up.
评估炎症标志物是否可预测行颈动脉支架置入术的严重颈动脉狭窄且无显著冠状动脉疾病患者颈动脉治疗后的动脉粥样硬化疾病活动。
2004 年 3 月 1 日至 2005 年 9 月 30 日，55 例连续严重颈动脉狭窄且无显著冠状动脉疾病患者（平均年龄 69±8.3 岁，26 例男性）接受颈动脉支架置入术治疗。对患者进行了 5 年的心血管事件随访。
发现滤器中捕获的碎屑的定量分析与炎症标志物之间存在显著相关性。此外，与无事件患者相比，随访时有临床事件的患者的每个滤器中的颗粒数、每个滤器的总颗粒面积和平均颗粒轴均显著更高（87 对 32，P=.006；50118.7 对 17782，P=.002；33.9 对 30.2，P=.03）。在 5 年随访期间，我们记录了 55 例患者中的 11 例（20%）发生了心血管或神经系统事件。术前较高的高敏 C 反应蛋白、白细胞介素 6 可溶性受体和白细胞介素 6 水平与随访时的临床事件显著相关（P<.001，P=.05 和 P=.02，分别）。特别是颈动脉支架置入术后 24 和 48 小时测量的高敏 C 反应蛋白与临床事件有显著相关性（P=.001）。另外，术前细胞间黏附分子 1 和循环血管细胞黏附分子 1 的血液浓度与随访时的预后不良显著相关（P=.04 和 P=.03，分别）。
在严重颈动脉狭窄且无显著冠状动脉疾病的患者中，炎症与动脉粥样硬化疾病活动和不良预后相关。白细胞介素 6、白细胞介素 6 可溶性受体、细胞间黏附分子 1、血管细胞黏附分子 1 和颈动脉支架置入术后 24 和 48 小时的高敏 C 反应蛋白水平可预测随访时的神经和心血管事件。
