title: Levels of circulating neopterin in patients with severe carotid artery stenosis undergoing carotid stenting.
abstract: OBJECTIVE
  The association between an elevated serum neopterin level and the development of coronary artery complex lesions has been extensively assessed; however, the correlation between the serum neopterin level and the development of carotid artery stenosis has seldom been reported. This study tested whether this biomarker is increased in patients with severe carotid artery stenosis(≥70%) undergoing carotid artery(CA) stenting and investigated independent predictors of an increased circulating neopterin level.
  
  
  METHODS
  Fifty patients with severe CA stenosis(CAS) undergoing CA stenting were consecutively enrolled in this study from January 2009 through December 2011. The serum neopterin levels of age- and gender-matched acute ischemic stroke(AIS) patients(n=120) and control subjects(CS)(n=33) were also measured. A blood sample was prospectively collected from each patient in the catheterization room.
  
  
  RESULTS
  The serum levels of neopterin were significantly higher in the CAS patients than in the AIS patients or CS and significantly higher in the AIS patients than in the CS(all p＜0.001). An analysis of the variables of 170 patients(CAS＋AIS) demonstrated that age, a previous history of stroke and severe CAS were significantly correlated with an increased serum level of neopterin(all p＜0.005). A multivariate binary logistic regression analysis of the severe CAS patients(n=50) demonstrated that age and the creatinine level were independent predictors of a high neopterin level(neopterin level ≥16.52 ng/dL, i.e., according to the median value of neopterin)(all p＜0.05).
  
  
  CONCLUSIONS
  The circulating neopterin levels are significantly higher in patients with severe CAS than in those with AIS. The presence of CAS, age and the creatinine level were significantly correlated with an increased serum neopterin level.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.
authors.forename: Yung-Lung
authors.initials: YL
authors.lastname: Chen
authors.forename: Tzu-Hsien
authors.initials: TH
authors.lastname: Tsai
authors.forename: Pei-Hsun
authors.initials: PH
authors.lastname: Sung
authors.forename: Hui-Ting
authors.initials: HT
authors.lastname: Wang
authors.forename: Hung-Sheng
authors.initials: HS
authors.lastname: Lin
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Shu-Feng
authors.initials: SF
authors.lastname: Chen
authors.forename: Chi-Ren
authors.initials: CR
authors.lastname: Huang
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.forename: Chiung-Jen
authors.initials: CJ
authors.lastname: Wu
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016893:Carotid Stenosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents
chemical_list: D015415:Biomarkers; D019798:Neopterin