Authors:
M. Kalovoulos, A. Papagianni, D. Kirmizis, D. Daravingas, A. Vainas, A.-M. Belechri, E. Alexopoulos, D. Memmos; Thessaloniki/GR
DOI:
10.1594/ECR03/C-1052
Conclusion
In accordance with previous reports, the present study demonstrated a significant association between IMT and CRP values (5-7). In addition, CRP was found to be a significant contributor to plaque score on both univariate and multivariate analysis, indicating that CRP is a valuable surrogate marker for atherosclerotic vascular damage. An interesting finding in the present study was the highly significant association observed between carotid IMT and serum ICAM-1 and VCAM-1 levels. Multivariate analysis showed that ICAM-1 levels were a strong independent correlate of IMT, whereas CRP became a significant correlate of IMT only when ICAM-1 levels were excluded from the analysis. Furthermore, this association appeared to be minimally influenced by a number of traditional or uraemia-related risk factors for atherosclerosis, including previous cardiovascular complications. The above data support the concept that measurements of these molecules could probably help to construct a better model for predicting atherosclerotic disease than models based only on classic risk factors and other markers of inflammation. ICAM-1 and VCAM-1 concentrations were not correlated with plaque score either on univariate or multivariate analyses, a finding which might indicate that these molecules could have a more important role on the early pathophysiological events than on the more advanced stages of atherosclerosis. In conclusion, in HD patients, carotid atherosclerosis is associated with inflammation and circulating levels of ICAM-1 and VCAM-1. Larger additional studies are needed to determine the potential value of these proteins as surrogate markers for early atherosclerosis and for global cardiovascular risk assessment in this high-risk population.