|Title:||Inflammatory markers and extent and progression of early atherosclerosis: Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration||Authors:||KUO-LIONG CHIEN
De Groot E.
|Issue Date:||2016||Publisher:||SAGE Publications Inc.||Journal Volume:||23||Journal Issue:||2||Start page/Pages:||194-205||Source:||European Journal of Preventive Cardiology||Abstract:||
Background Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population. Methods Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses. Results Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p < 0.001); 0.0072 mm for fibrinogen (p < 0.001); and 0.0025 mm for leucocyte count (p = 0.033). 'Inflammatory load', defined as the number of elevated inflammatory markers (i.e. in upper two quintiles), showed a positive linear association with baseline CCA-IMT (p < 0.001). Longitudinal associations of baseline inflammatory markers and changes therein with CCA-IMT progression were null or at most weak. Participants with the highest 'inflammatory load' had a greater CCA-IMT progression (p = 0.015). Conclusion Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis. ? 2014 European Society of Cardiology.
|ISSN:||2047-4873||DOI:||10.1177/2047487314560664||SDG/Keyword:||biological marker; C reactive protein; fibrinogen; biological marker; C reactive protein; fibrinogen; arterial wall thickness; atherosclerosis; cohort analysis; cross-sectional study; disease course; human; inflammation; leukocyte count; priority journal; Review; atherosclerosis; blood; disease course; inflammation; leukocyte count; meta analysis; Atherosclerosis; Biomarkers; C-Reactive Protein; Carotid Intima-Media Thickness; Disease Progression; Fibrinogen; Humans; Inflammation; Leukocyte Count
|Appears in Collections:||醫學系|
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