Circulating markers of inflammation are related to carotid artery atherosclerosis.

AIM: The role of inflammation in atherothrombotic disorders is becoming increasingly recognized. The present study prospectively investigates relationships between inflammatory markers and hemostatic variables, and non-invasive measures of carotid artery atherosclerosis. METHODS: Markers of hemostasis (sP-selectin and fibrinogen), cytokines (IL-6, IL-8, TNF-a and MCP-1), inflammatory variables (hsCRP, SAA and calprotectin) and cell adhesion molecules (ICAM-1 and VCAM-1) as well as ultrasonography of the carotid arteries were assessed in 111 consecutive outpatients with manifest or suspected coronary artery disease (CAD). RESULTS: Thirty-eight patients with manifest cardiovascular disease had higher IL-6 (P < 0.01) but not hsCRP levels. Higher levels of IL-6, calprotectin and VCAM-1 (all P < 0.05) were found in 35 patients with carotid plaques. In the whole study population (n = 109) an increased common carotid artery lumen diameter (LD) and cross sectional intima-media area (CIMA) was related to higher IL-6, IL-8 and MCP-1 levels (all P < 0.05), and increased LD also to higher hsCRP, calprotectin (both P < 0.05), sP-selectin and fibrinogen levels (both P < 0.01). Both LD and CIMA were related to VCAM-1 (both P < 0.01), but not to ICAM-1 levels. The intima-media thickness of the carotid artery was only positively related to MCP-1 levels (P < 0.05). Only the relation between IL-6 and LD remained significant after adjustment for age, gender, body mass index, smoking status or present lipid-lowering treatment. CONCLUSIONS: Several biomarkers of inflammation are related to ultrasonographic measures of carotid artery atherosclerosis in patients with moderate to high prevalence of CAD. IL-6 seems to be an independent and useful biomarker of atherosclerosis in this group of patients.

Carotid atherosclerosis in relation to symptoms from the territory supplied by the carotid artery.

OBJECTIVES: To investigate the relationship between intima-media thickness in the common carotid artery, plaque morphology in the carotid bifurcation and symptoms of cerebral embolism. Design prospective study of consecutive patients referred for carotid duplex examination. METHODS: One hundred and eighty-eight patients were classified by one of two neurologists into four categories (symptomatic, asymptomatic, undefined, uncertain). Carotid atherosclerosis was measured by means of high-resolution ultrasound technique. Carotid plaques were classified based on visual evaluation of plaque echogenicity. RESULTS: Intima-media thickness (IMT) was correlated to presence of plaques, age and gender, but not to symptoms referable to the carotid circulation. Carotid plaques were more common in symptomatic than in asymptomatic vessels (p<0.05). There was no difference in plaque occurrence between the ipsi- and contralateral sides in the symptomatic patients, neither in frequency of echolucent plaques between the sides or between symptomatic and asymptomatic patients. Echogenic plaques were more common and generally smaller than echolucent plaques. CONCLUSIONS: IMT correlates with presence of plaques, but not with symptoms from the territory supplied by the carotid artery. Echolucent plaques in the carotid bifurcation are not more frequently symptomatic than echogenic plaques are, in patients with low-to-moderate degree of carotid stenosis.

Relationship between intima-media thickness in the common carotid artery and atherosclerosis in the carotid bifurcation.

BACKGROUND AND PURPOSE: An increase in intima-media thickness (IMT) in the common carotid artery (CCA) is commonly used as a marker of atherosclerosis. The purpose of this study was to investigate the relationship between IMT in the CCA and atherosclerosis in the carotid bifurcation. METHODS: 182 consecutive patients (mean age, 67 years) referred for carotid duplex scanning were included. We measured IMT and classified plaques by means of a high-resolution ultrasound technique. RESULTS: IMT was correlated to age, male gender, ischemic heart disease, and presence of plaques or stenoses in any of the carotid bifurcations. In men, IMT was larger on the left than on the right side. Plaques were seen in 163 carotid bifurcations, in 45 of these with > 50% stenosis. On the left side but not on the right, there was a correlation between IMT in the CCA and presence of plaques or stenoses in the carotid bifurcation. Echogenic plaques were more common than echolucent, but the latter caused significantly more stenoses. No relationship was found between plaque echogenicity and IMT. CONCLUSIONS: IMT of the CCA is correlated to the degree of atherosclerosis in the carotid bifurcations in general and on the left side also to the presence of plaques or stenoses in the left carotid bifurcation. Our results support earlier observations suggesting faster development of carotid atherosclerosis on the left than on the right side. Echogenic plaques were more common and generally smaller than echolucent plaques, but there was no correlation between plaque echogenicity and IMT.