ABSTRACT
BACKGROUND: C-reactive protein (CRP) as a non-specific inflammatory biomarker has been demonstrated to actively contribute to all stages of atherogenesis. The aim of this study was to investigate the relation between CRP concentrations and the severity of stenosis of cerebral arteries. METHODS: Lipid parameters and CRP levels were measured in the sera of 119 patients with stenosis of the extracranial cerebral arteries established by angiography and compared with the control group, with a normal appearance of the cerebral arteries on ultrasound examination. CRP concentrations were determined by a high-sensitivity assay. RESULTS: CRP concentrations showed a statistically significant difference in the group of patients with cerebrovascular stenosis of more than 70% compared to the control group (median value 3.4 vs. 1.5 mg/l in the control group, p < 0.05). At logistic regression analysis, CRP was significantly associated with stenosis of more than 70%. CONCLUSION: In addition to traditional biochemical risk markers, an elevated CRP level measured on automated analysers using a high-sensitivity assay may be useful in the detection of patients with severe stenosis of the cerebral arteries.
Subject(s)
C-Reactive Protein/metabolism , Cerebral Arteries/pathology , Intracranial Arteriosclerosis/blood , Intracranial Arteriosclerosis/diagnosis , Adult , Aged , Aged, 80 and over , Angiography, Digital Subtraction , Biomarkers/blood , Constriction, Pathologic/blood , Female , Humans , Immunoassay/methods , Intracranial Arteriosclerosis/pathology , Lipids/blood , Logistic Models , Male , Middle Aged , Nephelometry and Turbidimetry , Predictive Value of Tests , Sensitivity and Specificity , Severity of Illness Index , Ultrasonography, Doppler, DuplexABSTRACT
AIM: To determine the significance of the association between biochemical risk factors for cerebrovascular atherosclerosis (lipid parameters, lipoprotein(a), total homocysteine, total antioxidant status, trace elements, and electrolytes) and the degree of stenosis of cerebral arteries scored by digital subtraction angiography. METHODS: The study included 35 patients with angiographically established < 50% stenosis of cerebral arteries and 55 patients with > or =50% stenosis of cerebral arteries, including obliteration. The control group consisted of 51 patients with normal cerebral arteries on ultrasound examination. Biochemical parameters were measured in all participants according to the standard laboratory protocols. RESULTS: Logistic regression analysis showed two independent and significant biochemical risk factors associated with the severity of cerebrovascular stenosis: lipoprotein(a) for patients with different degrees of stenosis, and total antioxidant status for patients with severe stenosis of more than 50%. Univariate statistical evaluation showed significantly higher homocysteine levels in the group of patients with > or =50% stenosis than in the control group (median 14.84 micromol/L vs median 12.40 micromol/L, p < 0.05). CONCLUSION: Increased lipoprotein(a) and low total antioxidant status values seem to be the most significant independent biochemical risk factors for the development of cerebrovascular stenosis. Mild hyperhomocysteinemia seems to be an additional discriminating indicator of the severe cerebrovascular stenosis. These factors may be useful for early identification and recognition of patients with cerebrovascular atherosclerosis.
