title: Relationship between carotid intima-media thickness, cytokines, atherosclerosis extent and a two-year cardiovascular risk in patients with arteriosclerosis.
abstract: OBJECTIVE
  To investigate the relationship between carotid intima-media thickness (CIMT), biomarkers, atherosclerosis extent and a two-year cardiovascular (CV) event risk in patients with arteriosclerosis.
  
  
  METHODS
  The CIMT, levels of high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor alpha (TNF-α), transforming growth factor beta (TGF-β), interleukin-6 (IL-6), interleukin-10 (IL-10), and NT-proBNP were measured in 279 subjects with atherosclerotic disease, mean age 64.1 ± 9.6 years. The patients were included when they had artery stenosis ≥ 50% in one, two, three or four arterial territories (coronary, supra-aortic, renal and/or lower limb arteries), and this was found in 97, 80, 69 and 33 patients, respectively. During a two-year follow-up, the incidences of CV death, myocardial infarction, ischaemic stroke and lesion progression were recorded.
  
  
  RESULTS
  The identified independent predictors of ≥ 3-territorial stenoses ≥ 50% were CIMT > 1.3 mm (RR 1.72; p < 0.001), hs-CRP > 5 mg/dL (RR 1.28; p = 0.005), IL-6 > 6.5 pg/mL (RR 1.08; p = 0.089), IL-10 (RR 0.86; p = 0.002), diabetes (RR 1.11; p = 0.027), total-cholesterol (RR 1.21; p < 0.001), creatinine (RR 1.15; p = 0.004) and body mass index (RR 0.85; p = 0.001). During a two-year follow-up, CV events occurred in 52 (18.6%) patients. The CIMT > 1.3 mm (p < 0.001), diabetes (p = 0.018), TNF-α > 6 pg/mL (p = 0.018), LDL-cholesterol > 3.35 mmol/L (p = 0.012) and NT-proBNP (p = 0.074) were independent CV event risk factors associated with a 27%, 14%, 15%, 15% and 11% higher CV risk, respectively. However, after adjustment for a baseline location of artery stenosis ≥ 50%, CIMT became a non-significant predictor (p = 0.245).
  
  
  CONCLUSIONS
  Levels of hs-CRP, IL-6, IL-10 are independently associated with atherosclerosis extent, while TNF-α and NT- -proBNP are mostly related to a two-year CV event risk. The CIMT > 1.3 mm seems to be a clinically relevant marker associated with atherosclerosis extent and CV risk, although CV event risk is primarily related to the baseline stenosis location.
authors: Department of Cardiac and Vascular Diseases, Jagiellonian University, School of Medicine, The John Paul II Hospital, Krakow, Poland. kablakziembicka@op.pl
authors: Anna
authors: A
authors: Kabłak-Ziembicka
authors: Tadeusz
authors: T
authors: Przewłocki
authors: Ewa
authors: E
authors: Stępień
authors: Piotr
authors: P
authors: Pieniążek
authors: Daniel
authors: D
authors: Rzeźnik
authors: Dorota
authors: D
authors: Sliwiak
authors: Monika
authors: M
authors: Komar
authors: Wiesława
authors: W
authors: Tracz
authors: Piotr
authors: P
authors: Podolec
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D016207:Cytokines / Q000097:blood*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000378:metabolism*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016207:Cytokines; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein