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Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease
Open accessAbstract
Background —Elevated C-reactive protein (CRP) serum levels, an exquisitely sensitive objective marker of inflammation, relate to long-term prognosis in patients with coronary artery disease and in apparently healthy men. Because abnormalities of endothelial regulation of vascular function may contribute to the occurrence of coronary events, we tested the hypothesis that elevated CRP levels are associated with an abnormal systemic endothelial vascular reactivity. Methods and Results —Endothelium-dependent (10 to 50 μg/min acetylcholine) and endothelium-independent (2 to 8 μg/min sodium nitroprusside) forearm blood flow responses were measured with venous occlusion plethysmography in 60 male patients with angiographically documented coronary artery disease. Forearm blood flow responses to acetylcholine were inversely correlated with CRP serum levels ( r =−0.46, P =0.001). With multivariate analysis that included the classic risk factors for coronary artery disease, elevated CRP serum level remained a statistically significant independent predictor of a blunted endothelial vasodilator capacity. Most important, normalization of elevated CRP levels over time was associated with a normalization of endothelium-mediated forearm blood flow responses after 3 months. Conclusions —Thus, elevated CRP serum levels indicative of a systemic inflammatory response are associated with a blunted systemic endothelial vasodilator function. The identification of elevated CRP levels as a transient independent risk factor for endothelial dysfunction might provide an important clue to link a systemic marker of inflammation to atherosclerotic disease progression.
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“inflammation is associated with anabolic resistance in muscle, which is caused partly by inhibition of the perfusion adjustment to anabolic stimuli and partly by inhibition of IGF1 production and signalling”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [240]
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Novel Immune Mechanisms in Hypertension and Cardiovascular Risk
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Boehncke, S., Fichtlscherer, S., Salgo, R., Garbaravičienė, J., Beschmann, H. A., Diehl, S., Hardt, K., Thaçi, D., & Boehncke, W. (2010) · Archives of Dermatological Research · doi:10.1007/s00403-010-1108-6 · Cited by 70
“The emerging hypothesis of continuous systemic anti-inflammatory therapy re-establishing a state of physiologic insulin sensitivity and normal endothelial vasodilator function has been tested in the prospective and longitudinal study reported here, employing invasive FBF measurements as the current gold standard for t…”
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Güngör, Ö., Ünal, H. U., Güçlü, A., Gezer, M., Eyileten, T., Güzel, F. B., Altunören, O., Erken, E., Oğuz, Y., Kocyigit, I. D., et al. (2017) · PLoS ONE · doi:10.1371/journal.pone.0178939 · Cited by 70
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“Several observations demonstrated that CRP levels correlated inversely with endothelial vasoreactivity in vivo [ 53 , 54].The most compelling data implicating CRP as a determinant of ED were studies demonstrating that human CRP reduced basal and stimulated nitric oxide release from arterial and venous endothelial cell…”
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C-Reactive Protein Suppresses Insulin Signaling in Endothelial Cells: Role of Spleen Tyrosine Kinase
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Tumor Necrosis Factor-α Antagonism Improves Endothelial Dysfunction in Patients With Crohn's Disease
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“Conversely, normalization of CRP levels over time has been found to associate with significant improvement of endothelium-dependent vascular reactivity.(17) In addition, endothelial dysfunction is a common feature in patients with chronic inflammatory diseases, such as rheumatoid arthritis(11,12) and systemic lupus er…”
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“10 In vitro studies have further shown that CRP induces adhesion molecule expression in human endothelial cells in the presence of serum.”
Lundman, P., Eriksson, M. J., Silveira, A. M. V., Hansson, L., Pernow, J., Ericsson, C.-G. Ö., Hamsten, A., & Tornvall, P. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00165-6 · Cited by 68
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Self-citationAbsence of Association Between Infectious Agents and Endothelial Function in Healthy Young Men
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Vascular Aging: Assessment and Intervention
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“Atherosclerosis is considered a chronic inflammatory disease [ , , , ,”
BackgroundBiomarkers of Inflammation and Oxidative Stress in Atherosclerosis
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Protection of Endothelial Function: Targets for Nutritional and Pharmacological Interventions
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“Interestingly, inflammation in turn induces endothelial dysfunction with decreased NO bioavailability.(6,7) Acute-phase HDL is relatively poor in apoA-I and paraoxonase and becomes proinflammatory and prooxidant.”
BackgroundAortic Stiffness: Epidemiology, Risk Factors, and Relevant Biomarkers
Angoff, R., Mosarla, R. C., & Tsao, C. W. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.709396 · Cited by 64
“A potential mechanism may lie in endothelial dysfunction: in men with coronary artery disease with forearm blood flow response studied with venous occlusion plethysmography, CRP levels were associated with blunted endothelial vasodilator capacity in models including risk factors (130).”
BackgroundHMG-CoA Reductase Inhibition: Anti-Inflammatory Effects beyond Lipid Lowering?
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Endothelial progenitor cells in patients with essential hypertension
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Metadata
- Authors
- Fichtlscherer, S., Rosenberger, G., Walter, D. H., Breuer, S., Dimmeler, S., & Zeiher, A. M.
- Affiliations
- Goethe University Frankfurt (DE)
- Venue
- Circulation
- Published
- 2000-08-29
- Volume
- 102
- Issue
- 9
- Pages
- 1000-1006
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2076633296
- Cited by
- 665
- References
- 25
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 8 · 2022: 9 · 2021: 14 · 2020: 11 · 2019: 11 · 2018: 17 · 2017: 16 · 2016: 18 · 2015: 18 · 2014: 26 · 2013: 27 · 2012: 21
- FWCI
- 23.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- C-reactive protein, coronary artery disease, endothelial dysfunction, endothelium-dependent vasodilation, acetylcholine response, forearm blood flow, systemic inflammation, cardiovascular risk factors, atherosclerosis, sodium nitroprusside
- MeSH terms
- Acetylcholine, Adrenergic beta-Antagonists, Aspirin, Brachial Artery, C-Reactive Protein, Coronary Disease, Endothelium, Vascular, Follow-Up Studies, Forearm, Humans, Inflammation, Infusions, Intra-Arterial, Male, Middle Aged, Nitroprusside, Regional Blood Flow, Risk Factors, Vasodilation, Vasodilator Agents, Biomarkers, Multivariate Analysis
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