Elevated C-reactive protein levels and impaired endothelial vasoreactivityin patients with coronary artery disease

Citation
S. Fichtlscherer et al., Elevated C-reactive protein levels and impaired endothelial vasoreactivityin patients with coronary artery disease, CIRCULATION, 102(9), 2000, pp. 1000-1006
Citations number
25
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
102
Issue
9
Year of publication
2000
Pages
1000 - 1006
Database
ISI
SICI code
0009-7322(20000829)102:9<1000:ECPLAI>2.0.ZU;2-2
Abstract
Background-Elevated C-reactive protein (CRP) serum levels, an exquisitely s ensitive objective marker of inflammation, relate to long-term prognosis in patients with coronary artery disease and in apparently healthy men. Becau se abnormalities of endothelial regulation of vascular function may contrib ute to the occurrence of coronary events, we tested the hypothesis that ele vated CRP levels are associated with an abnormal systemic endothelial vascu lar reactivity. Methods and Results-Endothelium-dependent (10 to 50 mu g/min acetylcholine) and endothelium-independent (2 to 8 mu g/min sodium nitroprusside) forearm blood flow responses were measured with venous occlusion plethysmography i n 60 male patients with angiographically documented coronary artery disease . Forearm blood flow responses to acetylcholine were inversely correlated w ith CRP serum levels (r= -0.46, P=0.001). With multivariate analysis that i ncluded the classic risk factors for coronary artery disease, elevated CRP serum level remained a statistically significant independent predictor of a blunted endothelial vasodilator capacity. Most important, normalization of elevated CRP levels over time was associated with a normalization of endot helium-mediated forearm blood flow responses after 3 months. Conclusions-Thus, elevated CRP serum levels indicative of a systemic inflam matory response are associated with a blunted systemic endothelial vasodila tor function. The identification of elevated CRP levels as a transient inde pendent risk factor for endothelial dysfunction might provide an important clue to link a systemic marker of inflammation to atherosclerotic disease p rogression.