Background and Purpose
High-sensitivity C-reactive protein (hs-CRP) is a risk indicator for atherosclerosis. However, the association between hs-CRP and early carotid atherosclerosis progression is not well established. We undertook a prospective, community-based, observational study to address this question.
Common carotid artery intima-media thickness (IMT) and hs-CRP values were measured at baseline and after 2 years of follow-up in subjects ≥40 years of age who were participating in the Asymptomatic Polyvascular Abnormalities Community study. Association between hs-CRP values and IMT progression was determined before and after controlling for vascular risk factors.
IMT was measured in a total of 1918 subjects at baseline and 52.97% of those (1016 of 1918) had IMT progression after 2 years. No significant association between progression of IMT over a 2-year period and average hs-CRP levels was found (multivariate-adjusted, P for trend = .280). Both hs-CRP values measured at baseline (P = .836) and after 2 years of follow-up (P = .440) were not associated with IMT progression levels. Average hs-CRP values were not related to IMT progression levels in a dose–response manner (P = .784). In a subgroup analysis stratified by age and sex, hs-CRP values were also not significantly associated with IMT progression levels (P > .05).
Our results suggest that hs-CRP is not a predictor for the progression of early atherosclerotic changes of the carotid arteries. The hs-CRP levels in early atherosclerosis might be considered as risk markers rather than having a causal role.
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- Inflammation and atherosclerosis.Circulation. 2002; 105: 1135-1143
- Atherosclerosis. the road ahead.Cell. 2001; 104: 503-516
- Atherosclerosis.Nature. 2000; 407: 233-241
- C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men.Circulation. 2008; 118: 2243-2251
- Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein.N Engl J Med. 2008; 359: 2195-2207
- Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial.Lancet. 2009; 373: 1175-1182
- Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group.N Engl J Med. 1999; 340: 14-22
- The role of carotid arterial intima-media thickness in predicting clinical coronary events.Ann Intern Med. 1998; 128: 262-269
- Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging.Circulation. 1986; 74: 1399-1406
- Relevance of carotid stenosis progression as a predictor of ischemic neurological outcomes.Arch Intern Med. 2003; 163: 2285-2289
- Early-onset carotid atherosclerosis is associated with increased intima-media thickness and elevated serum levels of inflammatory markers.Stroke. 2003; 34: 58-63
- Elevated C-reactive protein is associated with an increased intima to media thickness of the common carotid artery.Cerebrovasc Dis. 2002; 13: 57-63
- Asymptomatic polyvascular abnormalities in community (APAC) study in China: objectives, design and baseline characteristics.PLoS ONE. 2013; 8: e84685
- Ideal cardiovascular health metrics and the risks of ischemic and intracerebral hemorrhagic stroke.Stroke. 2013; 44: 2451-2456
- Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association.Circulation. 2003; 107: 499-511
- Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis.Circulation. 2007; 115: 459-467
- Common carotid intima-media thickness predicts occurrence of carotid atherosclerotic plaques: longitudinal results from the Aging Vascular Study (EVA) study.Arterioscler Thromb Vasc Biol. 2000; 20: 1622-1629
- Effects of total pathogen burden on coronary artery disease risk and C-reactive protein levels.Am J Cardiol. 2000; 85: 140-146
- C-reactive protein modulates risk prediction based on the Framingham Score: implications for future risk assessment: results from a large cohort study in southern Germany.Circulation. 2004; 109: 1349-1353
- Progression of early carotid atherosclerosis is only temporarily reduced after antibiotic treatment of Chlamydia pneumoniae seropositivity.Circulation. 2004; 109: 1010-1015
- C-reactive protein predicts progression of atherosclerosis measured at various sites in the arterial tree: the Rotterdam Study.Stroke. 2002; 33: 2750-2755
- Noninvasive phenotypes of atherosclerosis: similar windows but different views.Stroke. 2004; 35: 649-653
- Intima-media thickness: a new tool for diagnosis and treatment of cardiovascular risk.J Hypertens. 2002; 20: 159-169
- Relationship between C-reactive protein and progression of early carotid atherosclerosis in hypertensive subjects.Stroke. 2004; 35: 1625-1630
- C-reactive protein and carotid intimal medial thickness in a community population.J Cardiovasc Risk. 2002; 9: 97-103
- Inflammatory mediators and cell adhesion molecules as indicators of severity of atherosclerosis: the Rotterdam Study.Arterioscler Thromb Vasc Biol. 2002; 22: 838-842
- High-sensitivity C-reactive protein is not associated with carotid intima-media progression: the carotid atherosclerosis progression study.Stroke. 2007; 38: 1774-1779
- Combined effects of hemoglobin A1c and C-reactive protein on the progression of subclinical carotid atherosclerosis: the INVADE study.Stroke. 2006; 37: 351-357
- High sensitivity C-reactive protein predicts the development of new carotid artery plaques in older persons.Nutr Metab Cardiovasc Dis. 2011; 21: 776-782
- Distinct risk profiles of early and advanced atherosclerosis: prospective results from the Bruneck Study.Arterioscler Thromb Vasc Biol. 2000; 20: 529-537
- Is high-sensitivity C-reactive protein associated with carotid atherosclerosis in healthy Koreans?.Eur J Cardiovasc Prev Rehabil. 2005; 12: 548-554
- Association of C-reactive protein with carotid atherosclerosis in men and women: the Framingham Heart Study.Arterioscler Thromb Vasc Biol. 2002; 22: 1662-1667
- Association between high sensitivity C-reactive protein and prevalence of asymptomatic carotid artery stenosis.Atherosclerosis. 2015; 246: 44-49
Published online: October 11, 2016
Accepted: September 11, 2016
Received in revised form: August 21, 2016
Received: July 4, 2016
This work is supported by the National Natural Science Foundation of China (No. 81202279), National Science and Technology Major Project of China (2011BAI08B02).
Anxin Wang and Xiaoya Huang contributed equally to this work.
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.