Key result
Elevated levels of uric acid and C-reactive protein were identified as independent predictors of carotid artery stenosis, with a one-unit increase in uric acid associated with a 2.2-fold increased risk of mild stenosis (OR 2.203).
Why the study?
Carotid artery disease increases the risk of stroke, but the relationship between carotid artery stenosis and inflammatory markers required further evaluation.
Observational (n=310)
No
Odds Ratio: 2.203 (95% CI 1.418–3.424)
p-value: p=<0.001
Elevated levels of C-reactive protein and uric acid are independent predictors of carotid artery stenosis severity and the presence of vulnerable soft plaques.
Should not yet change carotid stenosis management; leaves open whether uric acid or CRP are modifiable targets.
Background : Atherosclerosis is a disease that cholesterol plaque builds up inside arteries. The process of atherosclerosis starts when certain substances such as cholesterol, fats, and cellular waste products accumulate in the walls of arteries, and the immune system responds to these substances, triggering inflammation. Over time, this inflammation can cause the plaque to grow and harden, narrowing the artery and reducing blood flow. Carotid artery disease (CAD) is a conclusion of plaques in carotid artery. CAD can increase the risk of stroke, a potentially life-threatening condition that occurs when blood flow to the brain is interrupted. Objectives: The objectives of this study were to detect the association between carotid artery stenosis and inflammatory markers. Methods: This study was designed prospectively and included 109 and 100 patients having mild carotid stenosis and severe carotid stenosis, respectively. Further, 101 patients were included in the control group. The carotid ultrasonography was evaluated in all patients. After classifying the plaques into<60% (mild stenosis) and 60%>(severe stenosis) categories, they were also grouped into echogenicity plaques, namely, echolucent (soft) and echogenic (hard) plaques. Results: The uric acid (UA) values of the mild and severe stenosis groups were higher than that of the control group (P<0.01). The mean C-reactive protein (CRP) value was the highest in the severe stenosis group, and the lowest CRP value was found in the control group (P<0.01). A one-unit increase in UA could increase the risk by 2.203 times. The CRP value was higher in the soft lesion group without calcification than in the hard lesion group with calcification. Conclusion: Our findings demonstrated that age, UA, and CRP values were identified as predictors independent of each other in the development of carotid stenosis. Regarding plaque classification, our results identified CRP, mean platelet volume (MPV), white blood cell, and lymphocyte values as negative predictors. The findings of our study indicate that CRP and UA are valuable in predicting the severity of stenosis and the formation of soft plaque.
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Yıldırım et al. (2023) conducted an observational in Carotid artery stenosis (n=310). Uric acid and C-reactive protein vs. Lower levels / Healthy controls was evaluated on Risk of mild carotid artery stenosis (<60%) per one-unit increase in uric acid (OR 2.203, 95% CI 1.418-3.424, p=<0.001). Elevated levels of uric acid and C-reactive protein were identified as independent predictors of carotid artery stenosis, with a one-unit increase in uric acid associated with a 2.2-fold increased risk of mild stenosis (OR 2.203).
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