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Updated: Jul 16, 2026
A Human Ex Vivo Atherosclerotic Plaque Model to Study Lesion Biology
Published on: May 6, 2014
Inflammation, atherosclerotic burden and cardiovascular prognosis
Christine Espinola-Klein1, Hans J Rupprecht, Christoph Bickel
1Medical Department II, Johannes Gutenberg-University, Langenbeckstrasse 1, 55131 Mainz, Germany. espinola@uni-mainz.de
Insights
Fibrinogen and Interleukin-18 (IL-18) predict cardiovascular death. Fibrinogen also indicates atherosclerotic burden, while IL-18 does not correlate with disease extent.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Atherosclerosis Studies
Background:
- Atherosclerosis is a major cause of cardiovascular disease.
- Inflammatory markers play a role in cardiovascular prognosis.
- Understanding these markers aids in risk stratification.
Purpose of the Study:
- To assess the impact of inflammatory markers on atherosclerotic burden.
- To evaluate the predictive value of these markers for cardiovascular outcomes.
Main Methods:
- Prospective study of 720 patients undergoing coronary angiography.
- Sonographic examination of carotid and leg arteries.
- Measurement of C-reactive protein, fibrinogen, IL-18, and IL-6.
Main Results:
- Multi-vascular atherosclerosis, elevated IL-18, and elevated fibrinogen independently predicted cardiovascular death.
- Fibrinogen predicted both mortality and atherosclerotic burden.
- IL-18 predicted mortality but not atherosclerotic burden.
Conclusions:
- Fibrinogen is a significant predictor of cardiovascular mortality and atherosclerotic disease extent.
- Interleukin-18 (IL-18) predicts cardiovascular death independently of atherosclerotic burden.
- Inflammatory markers offer valuable insights into cardiovascular risk stratification.
Background:
The aim of this study was to evaluate the impact of various inflammatory markers on atherosclerotic burden and cardiovascular prognosis.
Methods:
In a prospective study 720 patients preceding coronary angiography were enrolled. In all patients carotid and leg arteries were examined using sonographic methods and C-reactive protein, fibrinogen, interleukin-18 (IL-18) and interleukin-6 have been determined. Patients were compared with regard to atherosclerotic burden: no clinically significant stenosis (N=57, 7.9%), coronary artery disease only (N=362, 50.3%), coronary artery disease with peripheral atherosclerosis (=multi-vascular atherosclerosis, N=301, 41.8%).
Results:
Follow-up data after a median of 6.5 years were available in 719 patients (99.9%), 75 patients (10.4%) died from cardiovascular causes. Presence of multi-vascular atherosclerosis, elevation of IL-18 and elevation of fibrinogen were independently related to cardiovascular death in a fully adjusted model Hazard ratio (95% confidence interval) 2.0 (1.2-3.5) for presence of multi-vascular atherosclerosis (P<0.01), 2.2 (1.2-3.9) for high fibrinogen (P<0.01) and 2.8 (1.6-4.9) for high IL-18 (P<0.0001)). Fibrinogen was achieved as independent predictor for both, mortality and atherosclerotic burden, whereas IL-18 was not related to atherosclerotic burden.
Conclusions:
IL-18 was an independent predictor for future cardiovascular death but was not associated with extent of atherosclerosis, whereas fibrinogen was independently related to cardiovascular death and extent of disease.
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