December 23, 2005Stroke110 citations

Markers of Inflammation and Infection Influence the Outcome of Patients With Baseline Asymptomatic Carotid Lesions

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Early stages of atherosclerosis / asymptomatic carotid lesions (n=668). Intervention: Markers of inflammation and infection, and asymptomatic carotid lesions vs. Normal levels or absence of lesions. Primary outcome: Cerebrovascular or cardiovascular events (p=<0.0001).

ECEgle Corrado MRManfredi Rizzo RTR Tantillo

Key Result

High levels of fibrinogen (P<0.0001), C-reactive protein (P=0.014), specific infections, and asymptomatic carotid lesions (P<0.0001) significantly predicted cerebrovascular or cardiovascular events.

Study Design

Type

Cohort (n=668)

PICO

Population

668 subjects with varying degrees of carotid intima-media thickness or asymptomatic carotid plaque, followed prospectively for 5 years.

Exposure / Comparator

Markers of inflammation and infection, and asymptomatic carotid lesions vs Normal levels or absence of lesions

Primary Outcome

Cerebrovascular or cardiovascular events, p=<0.0001

Main Result

p-value: p=<0.0001

Abstract

BACKGROUND AND PURPOSE: It is still in debate whether the evaluation of markers of infection and inflammation may be of importance for cerebrovascular and cardiovascular prevention, and we aimed to investigate this field in a prospective 5-year clinical follow-up study in patients with early stages of atherosclerosis. METHODS: We studied 668 subjects divided in 3 groups according to the results of carotid ultrasound examination: (1) normal subjects, if intima-media thickness (IMT) was 1.5 mm. Traditional cardiovascular risk factors were investigated, and laboratory analysis included measurement of plasma lipids, fibrinogen, C-reactive protein, IgG antibodies for helicobacter pylori (HP), cytotoxic HP, cytomegalovirus, and chlamydia pneumoniae. RESULTS: Cerebrovascular or cardiovascular events were registered in 18% of patients during the follow-up, and at multivariate analysis we found that the high levels of fibrinogen (P<0.0001) and C-reactive protein (P=0.014), the seropositivity to cytotoxic HP (P=0.001) and chlamydia pneumoniae (P=0.026), the presence of IMT or asymptomatic carotid plaque (P<0.0001), and the total burden of infections (P<0.0001) were the variables predictive of the clinical events. CONCLUSIONS: Beyond traditional cardiovascular risk factors, markers of inflammation and infections seem to significantly influence the occurrence of cerebrovascular and cardiovascular events in patients with baseline asymptomatic carotid lesions.

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Cite This Study

Corrado et al. (Fri,) conducted a cohort in Early stages of atherosclerosis / asymptomatic carotid lesions (n=668). Markers of inflammation and infection, and asymptomatic carotid lesions vs. Normal levels or absence of lesions was evaluated on Cerebrovascular or cardiovascular events (p=<0.0001). High levels of fibrinogen (P<0.0001), C-reactive protein (P=0.014), specific infections, and asymptomatic carotid lesions (P<0.0001) significantly predicted cerebrovascular or cardiovascular events.

synapsesocial.com/papers/6a71c29d31a3df824329cbf9 https://doi.org/https://doi.org/10.1161/01.str.0000198813.56398.14