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A Population-Based Transesophageal Echocardiographic Study

Yoram Agmon, MD; Bijoy K. Khandheria, MD; Irene Meissner, MD; Tanya M. Petterson, MS; W. Michael O'Fallon, PhD; David O. Wiebers, MD; Teresa J. H. Christianson, BS; Joseph P. McConnell, PhD; Jack P. Whisnant, MD; James B. Seward, MD; A. Jamil Tajik, MD

Arch Intern Med. 2004;164:1781-1787.

Background  An association between systemic inflammatory markers and the presence and severity of atherosclerotic plaques has not been demonstrated in a nonselected population. The purpose of this study was to examine the association of inflammatory markers with aortic atherosclerotic plaques in a sample of the general population and in a subgroup free of clinical vascular disease.

Methods  Transesophageal echocardiography was performed in 386 subjects (median age, 66 years; 53% men). We examined the association between systemic inflammatory markers and aortic atherosclerotic plaques.

Results  Aortic plaques were present in 267 subjects (69%). Plaques at least 4 and 6 mm thick and mobile debris were present in 114, 41, and 20 subjects, respectively. High-sensitivity C-reactive protein (hs-CRP) level was associated with the presence of aortic plaques, adjusting for age, sex, smoking status, and additional atherosclerosis risk factors. Among subjects with plaques, hs-CRP level was independently associated with plaques at least 6 mm thick; similar trends were observed for the associations of hs-CRP level with plaques at least 4 mm thick and mobile debris. In subjects with aortic plaques who were free of clinically apparent coronary artery or cerebrovascular disease, hs-CRP level was independently associated with plaques at least 6 mm thick.

Conclusions  Level of hs-CRP is independently associated with the presence and severity of aortic atherosclerotic plaques. These observations establish the association of systemic inflammation with anatomically defined atherosclerosis in the general population.

From the Division of Cardiovascular Diseases and Internal Medicine (Drs Agmon, Khandheria, Seward, and Tajik) and the Departments of Neurology (Drs Meissner and Wiebers), Health Sciences Research (Mss Petterson and Christianson and Drs O'Fallon and Whisnant), and Laboratory Medicine and Pathology (Dr McConnell), Mayo Clinic, Rochester, Minn. Dr Agmon is now with the Department of Cardiology, Rambam Medical Center, Haifa, Israel. The authors have no relevant financial interest in this article.

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