在一般中年人群中,高灵敏度C反应蛋白与冠状动脉样硬化之间存在关联
Sofia Cederström1, Pia Lundman2, Joakim Alfredsson3
1Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. sofia.cederstrom@ki.se.
Scientific reports
|July 27, 2023
概括
通过高灵敏度C反应蛋白 (hsCRP) 测量系统性炎症,在一般人群中显示出与冠状动脉样硬化病的弱相关性. 升高的hsCRP与非化斑块有关,但其在检测冠状动脉样硬化的传统风险因素之外的附加价值很低.
科学领域:
- 心血管医学 心血管医学
- 炎症研究 炎症研究
- 生物标记分析 生物标记分析
背景情况:
- 炎症和冠状动脉样硬化之间的联系已经确立,但系统性炎症标志物如hsCRP在一般人群中的作用仍然不清楚.
- 高敏感性C反应蛋白 (hsCRP) 是系统性炎症的标志物.
- 冠状动脉样硬化是一个重大的公共卫生问题.
研究的目的:
- 研究hsCRP水平与通过冠状动脉计算机断层扫描血管学 (CCTA) 检测到的冠状动脉动脉样硬化之间的关联.
- 评估hsCRP对传统风险因素在确定冠状动脉样硬化的附加值.
主要方法:
- 一项基于人口的队列研究 (SCAPIS) 涉及25408名年龄在50-64岁之间的个人.
- 冠状动脉样硬化被评估使用CCTA,通过冠状动脉段中的斑块存在来定义.
- 测量和分类hsCRP水平,对年龄,性别,传统风险因素和BMI进行统计调整.
主要成果:
- 升高的hsCRP (≥2.3 mg/L) 与任何冠状动脉样硬化,显著的狭窄 (≥50%),以及涉及≥4个段的弱相关性.
- 经过BMI调整后,相关性减弱,但高hsCRP仍然与非化斑块有关.
- 在传统风险因素之外,hsCRP对冠状动脉样硬化的预测值被发现很低.
结论:
- 当考虑传统风险因素时,hsCRP在检测冠状动脉样硬化方面具有有限的附加价值.
- hsCRP与非化斑块之间的关联可能部分解释其与临床冠状动脉事件的联系,尽管直接的因果途径不太可能.
- 进一步的研究可能会澄清hsCRP在特定斑块类型和临床结果中的作用.
相关概念视频
01:30Coronary Artery Disease I: Introduction
21
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
21
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
41
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
41
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
119
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
119
01:26Coronary Artery Disease IV: Preventive Measures
24
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
24
01:26Atherosclerosis III: Management
12
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
12
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
13
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
13