C-reactive protein level and traditional vascular risk factors in the prediction of carotid stenosis

Hypothesis There is no relationship between C-reactive protein (CRP) level and the presence and degree of carotid stenosis (null hypothesis). Design Institutional review board\u96approved cohort study. Setting Tertiary care regional medical center. Patients Patients (N =3D 146) referred to a vascular surgery clinic for possible carotid stenosis. Interventions Baseline serum high-sensitivity CRP level, low-density lipoprotein cholesterol (LDL-C) level, and other traditionally used vascular risk factors were assessed in all patients. All underwent vascular surgery clinical examination, including bilateral duplex ultrasonography of their carotid bifurcations. Main Outcome Measures The potential relationship between serum CRP level and the presence and degree of carotid stenosis, as well as the strength of this association with traditionally established demographic, historical, and laboratory risk factors such as age, hypertension, and LDL-C level. Results In unadjusted analysis, CRP level, coronary artery disease (CAD), and lower extremity peripheral vascular disease (PVD) positively correlated with carotid stenosis (Pearson product moment correlation r < 0.02 for all). Low-density lipoprotein cholesterol level and other risk factors, including age, sex, race/ethnicity, smoking history, hypertension, diabetes mellitus, and neurologic history, did not. The mean \ub1 SD CRP level was higher among 72 patients with carotid stenosis compared with that among 74 patients without carotid stenosis (3.7 \ub1 6.1 vs 1.9 \ub1 2.1 mg/L [to convert to nanomoles per liter, multiply by 9.524], P =3D.02), as were the baseline prevalences of CAD (49% vs 29%), PVD (27% vs 11%), and (84% vs 61%) (P < .03 for all). The mean \ub1 SD LDL-C levels were similar between the groups (92.3 \ub1 28.6 vs 95.8 \ub1 29.0 mg/dL [to convert to millimoles per liter, multiply by 0.0259], P =3D .8), and differences in the prevalences of other risk factors were not statistically significant. In multivariate regression analysis adjusting for age, sex, race/ethnicity, smoking history, hypertension, diabetes mellitus, recent neurologic symptoms (