title: Markers of inflammation and infection influence the outcome of patients with baseline asymptomatic carotid lesions: a 5-year follow-up study.
abstract: OBJECTIVE
  It is still in debate whether the evaluation of markers of infection and inflammation may be of importance for cerebrovascular and cardiovascular prevention, and we aimed to investigate this field in a prospective 5-year clinical follow-up study in patients with early stages of atherosclerosis.
  
  
  METHODS
  We studied 668 subjects divided in 3 groups according to the results of carotid ultrasound examination: (1) normal subjects, if intima-media thickness (IMT) was <0.9 mm; (2) with IMT, if IMT was between 0.9 and 1.5 mm; and (3) with asymptomatic carotid plaque, if IMT was >1.5 mm. Traditional cardiovascular risk factors were investigated, and laboratory analysis included measurement of plasma lipids, fibrinogen, C-reactive protein, IgG antibodies for helicobacter pylori (HP), cytotoxic HP, cytomegalovirus, and chlamydia pneumoniae.
  
  
  RESULTS
  Cerebrovascular or cardiovascular events were registered in 18% of patients during the follow-up, and at multivariate analysis we found that the high levels of fibrinogen (P<0.0001) and C-reactive protein (P=0.014), the seropositivity to cytotoxic HP (P=0.001) and chlamydia pneumoniae (P=0.026), the presence of IMT or asymptomatic carotid plaque (P<0.0001), and the total burden of infections (P<0.0001) were the variables predictive of the clinical events.
  
  
  CONCLUSIONS
  Beyond traditional cardiovascular risk factors, markers of inflammation and infections seem to significantly influence the occurrence of cerebrovascular and cardiovascular events in patients with baseline asymptomatic carotid lesions.
authors.affiliation: Division of Cardiology, University of Palermo, Palermo, Italy.
authors.forename: Egle
authors.initials: E
authors.lastname: Corrado
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.forename: Rosalba
authors.initials: R
authors.lastname: Tantillo
authors.forename: Ida
authors.initials: I
authors.lastname: Muratori
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonura
authors.forename: Giustina
authors.initials: G
authors.lastname: Vitale
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000473:pathology; D002097:C-Reactive Protein / Q000096:biosynthesis; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000473:pathology; D002319:Cardiovascular System / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000473:pathology; D016993:Chlamydophila pneumoniae / Q000378:metabolism; D003587:Cytomegalovirus / Q000378:metabolism; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D005340:Fibrinogen / Q000096:biosynthesis; D005500:Follow-Up Studies; D016480:Helicobacter pylori / Q000378:metabolism; D006801:Humans; D007074:Immunoglobulin G / Q000737:chemistry; D007239:Infections / Q000175:diagnosis*; D007249:Inflammation / Q000175:diagnosis*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000473:pathology; D013997:Time Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D014463:Ultrasonography
chemical_list: D007074:Immunoglobulin G; D008055:Lipids; D005340:Fibrinogen; D002097:C-Reactive Protein