Article

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.
CI - (c) The European Society of Cardiology 2014.

Langue : ANGLAIS