The prognostic value of the serum inflammatory biomarkers in patients with carotid atherosclerosis

Keywords: atherosclerotic carotid stenosis, atherosclerotic markers, lipoprotein-associated phospholipase A2, E-selectin, risk of stroke

Abstract

20 % of ischemic stroke appear to originate from carotid artery atherosclerotic disease. Serum biomarkers reflecting the activity of atherosclerotic process and may help for estimate risk of acute cerebrovascular events. Several serum inflammatory markers have been proposed for risk assessment, but their prognostic role less known.

The aim of this study is to clarify the prognostic value of biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 (Lp-PLA2) and E-selectin in patients with symptomatic and asymptomatic carotid stenosis.

Materials and methods. The study involved 106 patients with atherosclerotic carotid stenosis >50 % (74 men and 32 women, mean age 62.6±0.9) from which 76 symptomatic (35 with acute ipsilateral atherothrombotic stroke and 41 after carotid endarterectomy) and 30 asymptomatic patients. The control group consisted of age- and sex-matched 20 healthy subjects. The level of serum Lp-PLA2 and E-selectin was determined using a commercially available enzyme-linked immunosorbent assay kit.

Results. The level of Lp-PLA 2 was in general significantly higher (p<0.05) in patients groups than in the control group and most high Lp-PLA2 concentration was in groups of symptomatic patients who underwent carotid endarterectomy. The level of E-selectin in the study patients was significantly higher than in the control group (p<0.05). The correlation of Lp-PLA 2 with E-selectin was significant for total patients (R=0.365664, p=0.00085) and group after carotid endarterectomy (R=0.429143, p=0.01796), but not for asymptomatic group (p>0.05). Receiver Operating Characteristics curves of logistic regression models which takes into joint both indicators was specificity and sensitive for predicting the occurrence of ischemic stroke.

Conclusion. Conducted study show that the levels of Lp-PLA 2 and E-selectin have a significant impact on the development of stroke in patients with atherosclerotic carotid stenosis and can be used to predict it. A multidimensional model of the dependence of the probability of stroke on a linear combination of Lp-PLA 2 and E-selectin allows to obtaining significantly higher characteristics of the accuracy of stroke prediction than models with each factor alone.

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Author Biographies

Olga Dubenko, Kharkiv Medical Academy of Postgraduate Education

Department of Neurology and Neurosurgery

Tetyana Litovchenko , Kharkiv Medical Academy of Postgraduate Education

Department of Neurology and Child Neurology

Victoria Anysienkova, Kharkiv Medical Academy of Postgraduate Education

Department of Neurology and Neurosurgery

Maryna Nessonova, National University of Pharmacy

Department of Educational and Information Technologies

Liudmyla Kovalenko, V. N. Karazin Kharkiv National University

Department of General Practice – Family Medicine

References

Messas, E., Goudot, G., Halliday, A., Sitruk, J., Mirault, T., Khider, L. et. al. (2020). Management of carotid stenosis for primary and secondary prevention of stroke: state-of-the-art 2020: a critical review. European Heart Journal Supplements, 22 (Supplement_M), M35–M42. doi: http://doi.org/10.1093/eurheartj/suaa162

Den Hartog, A. G., Achterberg, S., Moll, F. L., Kappelle, L. J., Visseren, F. L. J., van der Graaf, Y. et. al. (2013). Asymptomatic Carotid Artery Stenosis and the Risk of Ischemic Stroke According to Subtype in Patients With Clinical Manifest Arterial Disease. Stroke, 44 (4), 1002–1007. doi: http://doi.org/10.1161/strokeaha.111.669267

Libby, P. (2012). Inflammation in Atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 32 (9), 2045–2051. doi: http://doi.org/10.1161/atvbaha.108.179705

Mayer, F. J., Binder, C. J., Wagner, O. F., Schillinger, M., Minar, E., Mlekusch, W. et. al. (2016). Combined Effects of Inflammatory Status and Carotid Atherosclerosis. Stroke, 47 (12), 2952–2958. doi: http://doi.org/10.1161/strokeaha.116.013647

Martinez, E., Martorell, J., Riambau, V. (2020). Review of serum biomarkers in carotid atherosclerosis. Journal of Vascular Surgery, 71 (1), 329–341. doi: http://doi.org/10.1016/j.jvs.2019.04.488

Rothwell, P. M., Gutnikov, S. A., Warlow, C. P. (2003). Reanalysis of the Final Results of the European Carotid Surgery Trial. Stroke, 34 (2), 514–523. doi: http://doi.org/10.1161/01.str.0000054671.71777.c7

Toth, P. P., McCullough, P. A., Wegner, M. S., Colley, K. J. (2010). Lipoprotein-associated phospholipase A2: role in atherosclerosis and utility as a cardiovascular biomarker. Expert Review of Cardiovascular Therapy, 8 (3), 425–438. doi: http://doi.org/10.1586/erc.10.18

Ammirati, E., Moroni, F., Norata, G. D., Magnoni, M., Camici, P. G. (2015). Markers of Inflammation Associated with Plaque Progression and Instability in Patients with Carotid Atherosclerosis. Mediators of Inflammation, 2015, 1–15. doi: http://doi.org/10.1155/2015/718329

Marnane, M., Prendeville, S., McDonnell, C., Noone, I., Barry, M., Crowe, M. et. al. (2014). Plaque Inflammation and Unstable Morphology Are Associated With Early Stroke Recurrence in Symptomatic Carotid Stenosis. Stroke, 45 (3), 801–806. doi: http://doi.org/10.1161/strokeaha.113.003657

Wang, C., Fang, X., Hua, Y., Liu, Y., Zhang, Z., Gu, X. et. al. (2017). Lipoprotein-Associated Phospholipase A2 and Risk of Carotid Atherosclerosis and Cardiovascular Events in Community-Based Older Adults in China. Angiology, 69 (1), 49–58. doi: http://doi.org/10.1177/0003319717704554

Kleber, M. E., Siekmeier, R., Delgado, G., Grammer, T. B., Winkelmann, B. R., Scharnagl, H. et. al. (2014). C-Reactive Protein and Lipoprotein-Associated Phospholipase A2 in Smokers and Nonsmokers of the Ludwigshafen Risk and Cardiovascular Health Study. Advances in Experimental Medicine and Biology, 832, 15–23. doi: http://doi.org/10.1007/5584_2014_6

Sarlon-Bartoli, G., Boudes, A., Buffat, C., Bartoli, M. A., Piercecchi-Marti, M. D., Sarlon, E. (2012). Circulating Lipoprotein-associated Phospholipase A2 in High-grade Carotid Stenosis: A New Biomarker for Predicting Unstable Plaque. European Journal of Vascular and Endovascular Surgery, 43 (2), 154–159. doi: http://doi.org/10.1016/j.ejvs.2011.10.009

Wijeratne, T., Menon, R., Sales, C., Karimi, L., Crewther, S. (2020). Carotid artery stenosis and inflammatory biomarkers: the role of inflammation-induced immunological responses affecting the vascular systems. Annals of Translational Medicine, 8 (19), 1276–1276. doi: http://doi.org/10.21037/atm-20-4388

Chan, J. M. S., Monaco, C., Wylezinska-Arridge, M., Tremoleda, J. L., Gibbs, R. G. J. (2014). Imaging of the Vulnerable Carotid Plaque: Biological Targeting of Inflammation in Atherosclerosis using Iron Oxide Particles and MRI. European Journal of Vascular and Endovascular Surgery, 47 (5), 462–469. doi: http://doi.org/10.1016/j.ejvs.2014.01.017

Puz, P., Lasek-Bal, A., Ziaja, D., Kazibutowska, Z., Ziaja, K. (2013). Inflammatory markers in patients with internal carotid artery stenosis. Archives of Medical Science, 2, 254–260. doi: http://doi.org/10.5114/aoms.2013.34533

Shah, Z., Masoomi, R., Thapa, R., Wani, M., Chen, J., Dawn, B. et. al. (2017). Optimal Medical Management Reduces Risk of Disease Progression and Ischemic Events in Asymptomatic Carotid Stenosis Patients: A Long-Term Follow-Up Study. Cerebrovascular Diseases, 44 (3-4), 150–159. doi: http://doi.org/10.1159/000477501

Kakkos, S. K., Kakisis, I., Tsolakis, I. A., Geroulakos, G. (2017). Endarterectomy achieves lower stroke and death rates compared with stenting in patients with asymptomatic carotid stenosis. Journal of Vascular Surgery, 66 (2), 607–617. doi: http://doi.org/10.1016/j.jvs.2017.04.053

Bonati, L. H., Gregson, J., Dobson, J., McCabe, D. J. H., Nederkoorn, P. J., van der Worp, H. B. et. al. (2018). Restenosis and risk of stroke after stenting or endarterectomy for symptomatic carotid stenosis in the International Carotid Stenting Study (ICSS): secondary analysis of a randomised trial. The Lancet Neurology, 17 (7), 587–596. doi: http://doi.org/10.1016/s1474-4422(18)30195-9

King, A., Shipley, M., Markus, H. (2013). The Effect of Medical Treatments on Stroke Risk in Asymptomatic Carotid Stenosis. Stroke, 44 (2), 542–546. doi: http://doi.org/10.1161/strokeaha.112.673608

Goudot, G., Khider, L., Pedreira, O., Poree, J., Julia, P., Alsac, J.-M. et. al. (2020). Innovative Multiparametric Characterization of Carotid Plaque Vulnerability by Ultrasound. Frontiers in Physiology, 11. doi: http://doi.org/10.3389/fphys.2020.00157


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Published
2021-07-30
How to Cite
Dubenko, O., Litovchenko , T., Anysienkova, V., Nessonova, M., & Kovalenko, L. (2021). The prognostic value of the serum inflammatory biomarkers in patients with carotid atherosclerosis . EUREKA: Health Sciences, (4), 26-33. https://doi.org/10.21303/2504-5679.2021.001969
Section
Medicine and Dentistry