Elevated C-reactive protein levels were inversely correlated with endothelium-dependent forearm blood flow responses to acetylcholine in men with coronary artery disease (r=-0.46, P=0.001).
Observational (n=60)
Are elevated C-reactive protein (CRP) levels associated with impaired systemic endothelial vascular reactivity in male patients with coronary artery disease?
Elevated CRP levels are independently associated with blunted systemic endothelial vasodilator function in men with CAD, and normalization of CRP over 3 months correlates with improved endothelial function.
Effect estimate: r=-0.46
p-value: p=0.001
BACKGROUND: Elevated C-reactive protein (CRP) serum levels, an exquisitely sensitive objective marker of inflammation, relate to long-term prognosis in patients with coronary artery disease and in apparently healthy men. Because abnormalities of endothelial regulation of vascular function may contribute to the occurrence of coronary events, we tested the hypothesis that elevated CRP levels are associated with an abnormal systemic endothelial vascular reactivity. METHODS AND RESULTS: Endothelium-dependent (10 to 50 microg/min acetylcholine) and endothelium-independent (2 to 8 microg/min sodium nitroprusside) forearm blood flow responses were measured with venous occlusion plethysmography in 60 male patients with angiographically documented coronary artery disease. Forearm blood flow responses to acetylcholine were inversely correlated with CRP serum levels (r=-0.46, P:=0.001). With multivariate analysis that included the classic risk factors for coronary artery disease, elevated CRP serum level remained a statistically significant independent predictor of a blunted endothelial vasodilator capacity. Most important, normalization of elevated CRP levels over time was associated with a normalization of endothelium-mediated forearm blood flow responses after 3 months. CONCLUSIONS: Thus, elevated CRP serum levels indicative of a systemic inflammatory response are associated with a blunted systemic endothelial vasodilator function. The identification of elevated CRP levels as a transient independent risk factor for endothelial dysfunction might provide an important clue to link a systemic marker of inflammation to atherosclerotic disease progression.
Fichtlscherer et al. (2000) conducted an observational in Coronary artery disease (n=60). Elevated C-reactive protein (CRP) levels was evaluated on Endothelium-dependent forearm blood flow responses to acetylcholine (r=-0.46, p=0.001). Elevated C-reactive protein levels were inversely correlated with endothelium-dependent forearm blood flow responses to acetylcholine in men with coronary artery disease (r=-0.46, P=0.001).