C-reactive protein is an independent predictor of the rate of increase in early carotid atherosclerosis

Background-An elevated plasma concentration of high-sensitivity C-reactive protein (hs-CRP) is a strong predictor of cardiovascular events. However, t here have been no longitudinal studies of the relations between development of atherosclerotic lesions and hs-CRP concentrations. Furthermore, it rema ins unknown whether increased hs-CRP concentrations result in the developme nt of atherosclerosis. Methods and Results-The study included 179 outpatients 40 to 79 years of ag e who were treated at our institute for traditional risk factors for cardio vascular disease. The patients had no evidence of advanced carotid atherosc lerosis at the time of baseline examination. Patients underwent repeated ul trasonographic evaluation of the carotid arteries for 35 +/- 10 months. Blo od samples were collected for hs-CRP measurements. Based on focal intima-me dia thickening greater than or equal to1.1 mm representing plaque, plaque n umber (PN) and plaque score (PS; the sum of all plaque thicknesses) were ca lculated. The development of atherosclerosis was estimated by the formula D elta value/year=(last value-baseline value)/number of follow-up years. Mult ivariate linear regression analysis revealed that the log-transformed value for hs-CRP concentration was not related to baseline PN or PS but was rela ted to Delta PN/year and Delta PS/year (beta =0.29 and 0.30; P <0.001 for b oth) independently of the effect of traditional risk factors. Conclusions-During the early stages of carotid atherosclerosis, the hs-CRP concentration is a marker of carotid atherosclerotic activity rather than e xtent of atherosclerosis.