The Correlation between Inflammatory Markers and Carotid Atherosclerotic Plaque Characteristics

This study aimed to explore the relationship between serum inflammatory biomarkers and the carotid atherosclerotic plaque characteristics, given prior evidence suggesting a key role of inflammation in the development of atherosclerosis.

In this prospective study, patients with carotid atherosclerotic plaque were recruited. Serum high-sensitivity CRP (Hs-CRP), homocysteine (Hcy) concentrations, and neutrophil-to-lymphocyte ratio (NLR) were obtained for all enrolled patients. Carotid atherosclerosis characteristics (such as intraplaque hemorrhage [IPH] and lipid-rich necrotic core [LRNC]) were determined by three-dimensional high-resolution vessel wall imaging. The associations between Hs-CRP, Hcy, NLR, and plaque characteristics were assessed.

In total, 128 patients (84.4% men; mean age, 58.0 ± 8.7 years) were included. Multivariate logistic regression indicated that increased Hs-CRP levels were associated with the presence of LRNC (OR = 1.23, 95% CI: 1.07-1.40, p = 0.003) and IPH (OR = 1.26, 95% CI: 1.10-1.45, p = 0.001). Multivariate linear regression confirmed a significant correlation between Hs-CRP level (β = 3.24, 95% CI: 0.66-5.81, p = 0.014) and the IPH volume. For plaque burden, higher Hs-CRP levels were associated with larger max normalized wall index (NWI) (β = 0.01, 95% CI: 0.00-0.02, p = 0.005) and larger Max wall thickness (β = 0.08, 95% CI: 0.02-0.14, p = 0.006). NLR and Hcy levels did not show significant associations with the carotid plaque characteristics.

Elevated Hs-CRP levels were found to be closely associated with plaque burden and vulnerable plaque characteristics. The relationship between the elevated Hs-CRP and plaque vulnerability highlights its potential role in risk stratification and early intervention strategies. Further validation in larger, multicenter population studies is required to confirm these associations.