Atherogenic progression of carotid stenosis associates selectively with monocyte fraction in circulating leukocytes

Humoral biomarkers of inflammation appear to correlate with future cardiovascular events warranting investigation of more specific associations between phenotypic subclasses of circulating cellular immunity and atherogenic progression of carotid stenosis. Retrospective study of carotid stenosis progression based on archived serial carotid duplex ultrasonography examinations in 100 patients. Predictors of atherogenic progression of carotid stenosis were sought using univariate and multivariate analysis of age, gender, hypertension, diabetes mellitus, smoking, peripheral blood leukocyte count and leukocyte differential profile, platelets, diastolic and systolic and mean arterial blood pressure, pulse pressure, creatinine, glucose, total-, HDL-, and LDL-cholesterol, triglycerides, and body mass index. Atherogenic progression of carotid stenosis was limited to patients with carotid stenosis at baseline (41/100) and exhibited a sporadic episodic temporal course. Univariate predictors of stenosis progression were diabetes mellitus, smoking, percent monocytes, and absolute monocyte count. Logistic regression demonstrated that monocytes as a percentage of circulating leukocytes [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.06-1.47, P=0.0093] and smoking (OR 7.09, 95% CI 1.97-25.43, P=0.0027) were independently associated with atherogenic epochs. A selective association between the fraction of monocytes among leukocytes in peripheral blood and atherogenic progression of carotid stenosis is described.