Key result
Concurrent treatment with RAS blockers and ASA was associated with lower expression of NFkappaB (25.4 vs 57.6 DU, P=0.03) and CRP in carotid artery plaques compared to controls.
Why the study?
Does concurrent treatment with RAS blockers and ASA reduce inflammatory marker expression in carotid plaques in patients undergoing carotid endarterectomy?
Observational (n=68)
Does concurrent treatment with RAS blockers and ASA reduce inflammatory marker expression in carotid plaques in patients undergoing carotid endarterectomy?
Combined treatment with RAS blockers and aspirin decreases inflammatory markers (NFkappaB and CRP) in human atherosclerotic plaques, supporting their role in mitigating atherosclerosis progression.
May attenuate carotid plaque inflammation; hypothesis-generating for combined RAS blocker-ASA effects on atherosclerosis progression.
BACKGROUND AND PURPOSE: The local renin-angiotensin system (RAS) and cyclooxygenase-2 contribute to the activation of nuclear factor kappaB (NFkappaB) and C-reactive protein (CRP). We hypothesized that the combination of RAS blockers (RASb) and ASA reduces NFkappaB and CRP within atherosclerotic plaques. METHODS: Patients undergoing carotid endarterectomy were divided into groups according to treatment (RASb-acetylsalicylic acid [ASA], ASA, RASb, and control). The expression of NFkappaB, CRP, and CD40L was analyzed through Western blots in the obtained plaques. RESULTS: Plaques from patients treated with the combination of RASb and ASA showed lower expression of NFkappaB (25.4+/-9.8 densitometric units [DU]) than those of the control group (57.6+/-13.2 DU, P=0.03) as well as lower expression of CRP (20.9+/-9.6 DU) than those of the other treatment groups (ASA 86.1+/-13 DU, RASb 88.4+/-31 DU, controls 67.8+/-18.6, P=0.004). A negative expression of NFkappaB was associated with a reduced incidence of symptoms compared with a positive expression (5/33 [15.1%] versus 14/35 [40%], P=0.031). CONCLUSIONS: The combined treatment with RASb and ASA decreases the expression of inflammatory markers in atherosclerosis in humans. This study supports the role of the local RAS and cyclooxygenase-2 in the progression of atherosclerosis.
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Sattler et al. (2004) conducted an observational in Carotid artery plaques (n=68). Concurrent treatment with RAS blockers and ASA vs. Control, ASA alone, or RASb alone was evaluated on Expression of NFkappaB in carotid artery plaques (densitometric units) (p=0.03). Concurrent treatment with RAS blockers and ASA was associated with lower expression of NFkappaB (25.4 vs 57.6 DU, P=0.03) and CRP in carotid artery plaques compared to controls.
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