Increased Serum CRP-Albumin Ratio Is Independently Associated With Severity of Carotid Artery Stenosis

Angiology ◽  
2020 ◽  
Vol 71 (8) ◽  
pp. 740-746 ◽  
Author(s):  
Tarik Yildirim ◽  
Tuncay Kiris ◽  
Eyüp Avci ◽  
Seda ElcimDurusoy Yildirim ◽  
Onur Argan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
Carotid Angiography ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Group I ◽  
Group Ii

Carotid artery stenosis (CAS), mainly caused by carotid atherosclerosis, is related to ischemic stroke. We investigated whether C-reactive protein (CRP) to albumin ratio (CAR) was associated with increased severity of carotid stenosis in patients undergoing carotid angiography. A total of 269 patients who were undergoing carotid angiography were included in this study. The patients were divided into 2 groups with respect to the severe CAS: group 1 (stenosis < 70%, n = 189) or group II (stenosis ≥ 70%, n = 80). C-reactive protein to albumin ratio was higher in group II compared to group I (0.56 ± 0.25 vs 0.14 ± 0.01, P < .001). The CAR (odds ratio [OR]: 1.051, 95%CI: 1.027-1.076, P < .001), neutrophil to lymphocyte ratio (NLR), and total cholesterol levels were independent predictors of severe CAS. The area under the receiver operating characteristic curve (area under the curve) for the CAR to predict severe CAS was 0.798 (95% CI: 0.741-0.854, P < .001). C-reactive to protein albumin ratio was an independent risk factor of severe CAS. Therefore, CAR might be considered a potential index in the severity of carotid artery disease.

scholarly journals Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Aldo Bonaventura ◽  
François Mach ◽  
Aline Roth ◽  
Sébastien Lenglet ◽  
Fabienne Burger ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Cardiovascular Events ◽  
Inflammatory Cells ◽  
Artery Stenosis ◽  
Major Adverse Cardiovascular Events ◽  
C Reactive Protein ◽  
Carotid Plaques ◽  
Reactive Protein ◽  
Serum Crp

Serum c-reactive protein (CRP) was suggested for the assessment of intermediate cardiovascular (CV) risk. Here, systemic or intraplaque CRP levels were investigated as predictors of major adverse cardiovascular events (MACEs) in patients with severe carotid stenosis. CRP levels were assessed in the serum and within different portions (upstream and downstream) of carotid plaques of 217 patients undergoing endarterectomy. The association between CRP and intraplaque lipids, collagen, neutrophils, smooth muscle cells (SMC), and macrophage subsets was determined. No correlation between serum CRP and intraplaque biomarkers was observed. In upstream portions, CRP content was directly correlated with intraplaque neutrophils, total macrophages, and M1 macrophages and inversely correlated with SMC content. In downstream portions, intraplaque CRP correlated with M1 and M2 macrophages. According to the cut-off point (CRP > 2.9%) identified by ROC analysis in upstream portions, Kaplan-Meier analysis showed that patients with high CRP levels had a greater rate of MACEs. This risk of MACEs increased independently of age, male gender, serum CRP, and statin use. In conclusion, in patients with severe carotid artery stenosis, high CRP levels within upstream portions of carotid plaques directly and positively correlate with intraplaque inflammatory cells and predict MACEs at an 18-month follow-up period.

scholarly journals A prospective evaluation of C-reactive protein in the progression of carotid artery stenosis

2008 ◽  
Vol 47 (4) ◽  
pp. 744-751 ◽  
Author(s):  
Zachary M. Arthurs ◽  
Charles Andersen ◽  
Benjamin W. Starnes ◽  
Vance Y. Sohn ◽  
Philip S. Mullenix ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Prospective Evaluation ◽  
C Reactive Protein ◽  
Reactive Protein

Transcarotid Artery Revascularization and Advances in Vascular Surgery for Carotid Artery Disease

2021 ◽  
Author(s):  
James Hu ◽  
◽  
Andy Sohn ◽  
Justin George ◽  
Rajesh Malik ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Vascular Surgery ◽  
Carotid Endarterectomy ◽  
Surgical Management ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
Cerebrovascular Accidents ◽  
Artery Disease

Carotid artery atherosclerotic disease impacts over 2 million Americans annually. Since the advent of the carotid endarterectomy by Debakey in 1953, the surgical management of carotid artery stenosis has prevented cerebrovascular accidents. The technology utilized to manage carotid artery stenosis continued to evolve with the utilization of carotid artery stenting in 1989 and more recently transcarotid artery revascularization (TCAR). This review discusses the modern management of carotid artery stenosis with an emphasis on transcarotid artery revascularization (TCAR) and reversal of flow for reversal of flow for embolic protection.

Angioplasty and stenting for carotid artery stenosis: indications, techniques, results, and complications

1998 ◽  
Vol 5 (6) ◽  
pp. E5 ◽  
Author(s):  
Giuseppe Lanzino ◽  
Richard D. Fessler ◽  
Robert A. Mericle ◽  
Ajay K. Wakhloo ◽  
Lee R. Guterman ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
High Risk Patients ◽  
Clinical Series ◽  
Risk Patients ◽  
Artery Disease ◽  
Angioplasty And Stenting

Following the favorable results obtained in the treatment of coronary artery disease, combined angioplasty and stenting has been advocated for the treatment of carotid artery stenosis as well. Although widespread application of angioplasty and stenting for carotid artery disease is neither indicated nor recommended, it may be a viable alternative therapy for select patients who are high-risk patients for surgery. The results of early series have suggested that endoluminal revascularization in these high-risk patients can be performed with an acceptable degree of safety. Although the incidence of death and major stroke rates following angioplasty and stenting procedures compares favorably with surgery, results of more recent clinical series have suggested that the incidence of perioperative transient neurological events and minor strokes may be higher than suggested by earlier reports, especially in patients with recent neurological symptoms and “unstable” plaques. In this article, the authors review the current potential indications for and preliminary results of angioplasty and stenting and describe their procedural technique. In addition, potential applications of stenting to intracranial thromboocclusive carotid artery disease are reviewed.

scholarly journals The CRP/albumin ratio: a novel predictor of in-stent restenosis after carotid artery stenting

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.N Calik ◽  
T Cinar ◽  
D Inan ◽  
D Genc ◽  
H Kuplay ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Independent Predictor ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Stent Restenosis ◽  
In Stent Restenosis

Abstract Background In-stent restenosis (ISR) remains a potential problem and raises concerns about the long-term safety and efficacy of carotid artery stenting (CAS). As inflammation has a pivotal role in the pathogenesis of ISR, a novel and more sensitive inflammatory marker, CRP/albumin ratio (CAR) may be used to predict ISR in patients undergoing CAS. Purpose The present study aimed to assess the predictive value of preprocedural C-reactive protein/albumin ratio (CAR) for ISR after CAS. Method In this retrospective study, 206 patients who underwent successful CAS procedure in a tertiary heart centre were included. For each patient, both C-reactive protein (CRP) and serum albumin were determined before the index procedure. The CAR was calculated by dividing serum CRP by serum albumin level. The main end-point of the study was ISR during long-term follow-up. Results ISR developed in 34 (16.5%) out of 206 patients after a mean follow-up of 24.2±1.5 months. The CAR was significantly elevated in patients with ISR compared to those who were not (0.99 [1.3] vs. 0.15 [0.2], p&lt;0.01, respectively). In a multivariate Cox regression analysis, the CAR was an independent predictor of ISR (HR: 1.85, 95% CI: 1.29–2.64, p&lt;0.01). A ROC curve analysis revealed that the optimal value of CAR in predicting ISR was &gt;0.53 with a sensitivity of 100% and a specificity of 97.1% [area under curve (AUC) 0.98, p&lt;0.001]. Conclusion The present study demonstrated that CAR, a new inflammatory-based index, is a strong independent predictor of ISR after CAS. As a simple and easily accessible parameter, this index may be used for the assessment of ISR in patients who are treated with CAS. Funding Acknowledgement Type of funding source: None

scholarly journals C-reactive Protein is Elevated in Symptomatic Compared with Asymptomatic Patients with Carotid Artery Disease

2002 ◽  
Vol 23 (6) ◽  
pp. 505-509 ◽  
Author(s):  
K. Rerkasem ◽  
C.P. Shearman ◽  
J.A. Williams ◽  
G.E. Morris ◽  
M.J. Phillips ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Asymptomatic Patients ◽  
Artery Disease
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