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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1962.)
© 2001 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Elevated C-Reactive Protein Constitutes an Independent Predictor of Advanced Carotid Plaques in Dyslipidemic Subjects

Robert Blackburn; Philippe Giral; Eric Bruckert; Jean-Michel André; Sophie Gonbert; Maguy Bernard; M. John Chapman; Gérard Turpin

From the Service d’Endocrinologie-Métabolisme; INSERM U 551, Dyslipoproteinemia and Atherosclerosis Research Unit, Service de Biochimie and Federated Research Institute, "Heart, Muscle, Vessels," Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

Reprint requests to Dr Philippe Giral, Unité de Prévention des Maladies Cardio-Vasculaires, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France. E-mail philippe.giral{at}psl.ap-hop-paris.fr

Inflammation plays a key role in the physiopathology of atherosclerosis. C-reactive protein (CRP) has been found to predict cardiac events in healthy subjects and in patients with coronary heart disease. However, the relationship between CRP and subclinical atherosclerosis is not well established. We examined the potential relationship between CRP and common carotid artery intima-media thickness and carotid plaques in dyslipidemic subjects. Dyslipidemic patients (n=1051) were recruited for the study. All patients had a complete clinical examination and systematically underwent ultrasonographic evaluation of the extracranial carotid arteries on a duplex system. The serum concentration of CRP was measured by using a sensitive immunoradiometric assay. In a univariate model, a strong positive relationship was found between CRP and the severity of carotid stenosis (P<0.0001). In multivariate analysis, the association between CRP and the degree of carotid atherosclerosis remained significant for advanced plaques (P=0.0007) in male subjects only. Significant correlations were found between CRP and body mass index (P<0.0001) and between CRP and other markers associated with the metabolic syndrome. In this large dyslipidemic population, elevated CRP is an independent predictor of advanced carotid plaques in male subjects. Body mass index and other markers of the metabolic syndrome (HDL cholesterol, triglycerides, diabetes, and high blood pressure) are significant determinants of CRP levels in this population.

Key Words: C-reactive protein • carotid plaques • inflammation • body mass index • intima-media thickness

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