Unstable angina and C-reactive protein >3 mg/L were independently associated with complex carotid plaques (OR 6.09; 95% CI 1.01-33.72 and OR 5.80; 95% CI 1.55-21.69, respectively).
Observational (n=365)
Are unstable angina and systemic inflammation associated with carotid plaque instability in patients undergoing coronary bypass surgery?
Unstable angina and elevated systemic inflammation are independently associated with complex carotid plaques, suggesting that atherothrombotic plaque instability may be a widespread, systemic process rather than confined to the coronary arteries.
Effect estimate: OR 6.09 (95% CI 1.01 to 33.72)
p-value: p=0.039
BACKGROUND: Multiple complex stenoses, plaque fissures, and widespread coronary inflammation are common in acute coronary syndromes. A systemic cause of atherosclerotic plaque instability is also suggested by studies of ischemic cerebrovascular disease. We investigated the association between coronary and carotid plaque instability and the potential common causal role of inflammation. METHODS AND RESULTS: The ultrasound characteristics of carotid plaques were evaluated retrospectively in patients scheduled for coronary bypass surgery, 181 with unstable and 92 with stable angina, and prospectively in a similar group of patients, 67 with unstable and 25 with stable angina, in whom serum C-reactive protein levels were also measured. The prevalence of carotid plaques was similar in the retrospective and prospective studies and >64% in both unstable and stable coronary patients. The prevalence of complex, presumably unstable carotid plaques was 23.2% in unstable versus 3.2% in stable patients (P3 mg/L were independently associated with complex carotid plaques (OR, 6.09; 95% CI, 1.01 to 33.72; P=0.039, and OR, 5.80; 95% CI, 1.55 to 21.69; P=0.009, respectively). CONCLUSIONS: In unstable angina, plaque instability may not be confined to coronary arteries, and inflammation may be the common link with carotid plaque instability. These observations may have relevant implications for understanding the mechanisms of acute widespread atherothrombotic plaque inflammation.
Lombardo et al. (2004)は、不安定および安定狭心症に関する観察研究を行いました (n=365)。 不安定狭心症と高値のC反応性タンパク質対安定狭心症と正常値のC反応性タンパク質が複雑な頸動脈プラークにおいて評価されました (OR 6.09, 95% CI 1.01から33.72, p=0.039)。 不安定狭心症およびC反応性タンパク質 >3 mg/L は複雑な頸動脈プラークと独立して関連していました (OR 6.09; 95% CI 1.01-33.72 および OR 5.80; 95% CI 1.55-21.69, それぞれ)。
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