Key result
Older age (OR 1.7), fibrinogen (OR 1.6), carotid lesions (OR 2.0), and hs-CRP (OR 1.3) were significant predictors of cardio- and cerebrovascular events in postmenopausal women over 5 years.
Why the study?
Do markers of inflammation (hs-CRP, fibrinogen) and older age predict cardio- and cerebrovascular events in postmenopausal women with asymptomatic carotid lesions?
Cohort (n=250)
Do markers of inflammation (hs-CRP, fibrinogen) and older age predict cardio- and cerebrovascular events in postmenopausal women with asymptomatic carotid lesions?
In postmenopausal women without known cardiovascular disease, older age, presence of carotid lesions, and elevated inflammatory markers (fibrinogen and hs-CRP) are strong independent predictors of future cardio- and cerebrovascular events.
Answers are grounded in this paper and cite their sources.
May refine risk stratification in postmenopausal women; hypothesis-generating for inflammation-targeted interventions.
OBJECTIVE: Limited information exists regarding the association between markers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP) and fibrinogen, and adverse events in postmenopausal women with subclinical atherosclerosis. Therefore, we investigated the prognostic impact of traditional risk factors and inflammation on adverse cardiac events in women with asymptomatic carotid lesions. DESIGN: We studied 250 postmenopausal women who were free of cardiovascular disease. Traditional cardiovascular risk factors were investigated, and laboratory analysis included measurement of plasma lipids, fibrinogen, and hs-CRP. The early phases of carotid atherosclerosis were assessed by B-mode ultrasonography. Women were asked about symptoms or a previous history of coronary artery disease and were followed for a period of 5 years. RESULTS: We found that the increment in age (in quintiles) was significantly associated with higher incidence of current smokers (P = 0.0286), hypertension (P = 0.0230), family history of coronary artery disease (P = 0.0216), dyslipidemia (P = 0.0330), and higher levels of fibrinogen (P = 0.0158). Moreover, older women had a higher prevalence of carotid lesions (P < 0.0001). After the follow-up, cardio- and cerebrovascular events were registered in 22% of the women. Using multivariate analysis, we observed that older age (odds ratio [OR], 1.7; 95% CI, 1.3-2.2; P < 0.0001), fibrinogen (OR, 1.6; 95% CI, 1.2-2.0; P < 0.0001), the presence of carotid lesions (OR, 2.0; 95% CI, 1.4-3.0; P = 0.0002), and hs-CRP (OR, 1.3; 95% CI, 1.2-2.0; P = 0.0175) were predictors of adverse events during the follow-up. CONCLUSIONS: Adverse events occurred more frequently in women with higher levels of fibrinogen and hs-CRP. The significance of these results requires confirmation in other studies, but they may have important implications for screening subjects at risk for cardiovascular disease and identifying candidates for anti-inflammatory therapy.
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Corrado et al. (2008) conducted a cohort in asymptomatic carotid lesions (n=250). Older age and markers of inflammation (fibrinogen, hs-CRP) was evaluated on cardio- and cerebrovascular events (OR 1.7, 95% CI 1.3-2.2, p=<0.0001). Older age (OR 1.7), fibrinogen (OR 1.6), carotid lesions (OR 2.0), and hs-CRP (OR 1.3) were significant predictors of cardio- and cerebrovascular events in postmenopausal women over 5 years.
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