Key result
Higher levels of inflammatory markers were independently associated with greater baseline CCA-IMT (mean difference 0.0082 mm per 1-SD higher hs-CRP, P<0.001).
Why the study?
Are elevated inflammatory markers associated with increased common-carotid-artery intima-media thickness and its progression in individuals without pre-existing cardiovascular disease?
Meta-Analysis (n=49,097)
Yes
Are elevated inflammatory markers associated with increased common-carotid-artery intima-media thickness and its progression in individuals without pre-existing cardiovascular disease?
Inflammatory markers are independently associated with baseline carotid intima-media thickness, supporting the role of inflammation in early atherosclerosis, though longitudinal associations with progression were weak.
Supports inflammation's role in early atherosclerosis; extends meta-analytic evidence on inflammatory markers in subclinical disease.
BACKGROUND: Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population. METHODS: Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses. RESULTS: Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p < 0.001); 0.0072 mm for fibrinogen (p < 0.001); and 0.0025 mm for leucocyte count (p = 0.033). 'Inflammatory load', defined as the number of elevated inflammatory markers (i.e. in upper two quintiles), showed a positive linear association with baseline CCA-IMT (p < 0.001). Longitudinal associations of baseline inflammatory markers and changes therein with CCA-IMT progression were null or at most weak. Participants with the highest 'inflammatory load' had a greater CCA-IMT progression (p = 0.015). CONCLUSION: Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis.
No takes yet. Share an insight, caveat, or question.
Willeit et al. (2014) conducted a meta-analysis in early atherosclerosis (n=49,097). Inflammatory markers (high-sensitivity C-reactive protein, fibrinogen, leucocyte count) was evaluated on baseline common-carotid-artery intima-media thickness (CCA-IMT) (MD 0.0082 mm for hs-CRP, 0.0072 mm for fibrinogen, 0.0025 mm for leucocyte count per 1-SD increase, p=<0.001). Higher levels of inflammatory markers were independently associated with greater baseline CCA-IMT (mean difference 0.0082 mm per 1-SD higher hs-CRP, P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: