title: C-reactive protein is elevated in symptomatic compared with asymptomatic patients with carotid artery disease.
abstract: OBJECTIVE
  to investigate the level of inflammatory markers between symptomatic and asymptomatic carotid stenosis patients.
  
  
  METHODS
  cross-sectional study.
  
  
  METHODS
  a prospective study of 137 consecutive patients, admitted electively for carotid endarterectomy during 1997-2000, was conducted. 125 patients had cerebrovascular symptoms: either stroke (neurological deficit >24 h), Transient ischaemic attack (neurological deficit<24 h) or amaurosis fugax. Twelve patients were asymptomatic. A medical history and a fasting venous blood sample were taken from each patient around 6 weeks before surgery. The plasma concentrations of cholesterol and of inflammatory markers; (high sensitivity C-reactive protein (hs-CRP), sICAM-1, sVCAM-1, sE-selectin) were determined.
  
  
  RESULTS
  the concentration of hs-CRP in the symptomatic group (3.9 mg/L) was significantly higher than in the asymptomatic group (2.1 mg/L; p = 0.04). These concentrations were within normal range (<10 mg/L). sICAM-1, sVCAM-1, sE-selectin and total cholesterol concentrations were not different between the two groups.
  
  
  CONCLUSIONS
  plasma hs-CRP was elevated in symptomatic compared to asymptomatic patients with carotid artery disease. High sensitivity C-reactive protein has been shown to be of prognostic value in a number of cardiovascular conditions and this study suggests it may be of value to identify patient at high risk of developing neurological deficits.
authors.affiliation: Department of Vascular Surgery, Southampton General Hospital, UK. kr4@soton.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Rerkasem
authors.forename: C P
authors.initials: CP
authors.lastname: Shearman
authors.forename: J A
authors.initials: JA
authors.lastname: Williams
authors.forename: G E
authors.initials: GE
authors.lastname: Morris
authors.forename: M J
authors.initials: MJ
authors.lastname: Phillips
authors.forename: P C
authors.initials: PC
authors.lastname: Calder
authors.forename: R F
authors.initials: RF
authors.lastname: Grimble
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016893:Carotid Stenosis / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D015815:Cell Adhesion Molecules / Q000097:blood; D003430:Cross-Sectional Studies; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D002097:C-Reactive Protein