P192	Markers of inflammation and vascular disease.
1E.Dósa, 1A.Szabó, 2S.Rugonfalvi-Kiss, 1L.Selmeci, 2G.Füst, 1L.Entz
1Department of Cardiovascular Surgery, Semmelweis University, Budapest, HU; 23rd Department of Internal Medicine, Semmelweis University, Budapest, HU.

OBJECTIVE: The purpose of the study was to investigate the putative role of inflammatory, haemostatic markers and genetic factors in severe carotid artery stenosis and restenosis. METHODS: We prospectively studied 137 patients who were undergoing elective carotid endarterectomy (2003-2004). The control group consisted of 104 healthy blood donors. Traditional risk factors for atherosclerosis were recorded and plasma soluble thrombomodulin (sTM), fibrinogen and serum high-sensitivity C-reactive protein (hs-CRP) concentrations were determined in each patient before surgery and at 6 weeks and 12 months postsurgery. Tumor necrosis factor-alfa (TNF-alfa) and mannose-binding lectin (MBL) promoter polymorphisms were also studied. Patients had duplex scan examinations before surgery and 6 weeks, 6 months and 12 months after the operations. RESULTS: (1.) Negative correlation was found between the preoperative duplex scan values and the plasma sTM concentrations (R=-0.418, p=0.0006). Patients with -308 A TNF-alfa genotype had significantly lower (p=0.0415) preoperative sTM values than their counterparts with no such polymorphism. Soluble TM concentrations measured in plasma samples taken at the end of the postsurgical follow-up period of 12 months duration were significantly higher compared to the preoperative values (p<0.0001). (2.) During the follow-up period we observed a sharp, highly significant drop in the serum and plasma concentrations of both acute-phase proteins (p<0.0001). (3.) In our prospective study the carotid duplex scan values increased highly significantly in patients with homozygous for the normal MBL genotype (p<0.001), while no significant increase was seen in the variant allele carriers (p>0.05). The protective association with MBL variant alleles was gene dose dependent (p=0.007). CONCLUSION: The inflammatory markers seem to be powerful humoral parameters of vascular disease in humans. Howevere, several issues have to be evaluated before the measurements of inflammatory markers could be used for risk prediction in clinical practice or in clinical trials evaluating anti-atherosclerotic drugs.

Copyright © 2005 S. Karger AG, Basel. Any further use of this abstract requires written permission from the publisher.