Cited by 665Nitric Oxide and Endothelin EffectsCardiovascular Health and Disease PreventionAtherosclerosis and Cardiovascular Diseases

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Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease

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Fichtlscherer, Stephan, Rosenberger, Gunter, Walter, Dirk H., Breuer, Susanne, Dimmeler, Stefanie, Zeiher, Andreas M.·2000·Circulation

DOI 10.1161/01.cir.102.9.1000

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Abstract

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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Elevated secretory non-pancreatic type II phospholipase A2 serum activity is associated with impaired endothelial vasodilator function in patients with coronary artery disease
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Self-citation
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Background
C-reactive protein predicts functional status and correlates with left ventricular ejection fraction in patients with chronic stable angina
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C-reactive protein as a predictor for poor collateral circulation in patients with chronic stable coronary heart disease
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Predictors of poor coronary collateral development in patients with stable coronary artery disease: Neutrophil-to-lymphocyte ratio and platelets
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“(24) showed that elevated CRP serum levels indicative of a systemic inflammatory response are associated with a profound impairment in systemic endothelial vascular reactivity in patients with coronary artery disease.”
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Deciphering Endothelial Dysfunction in the HIV-Infected Population
Mezoh, G., & Crowther, N. J. (2019) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-12668-1_11 · Cited by 21
Inflammation as a mediator of arterial ageing
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“…are positively correlated with pulse wave velocity (PWV; a measure of large artery stiffness) and inversely correlatedwith endothelium-dependent dilatation (EDD) in forearm resistance arteries (Fichtlscherer et al., 2000; Lind, Siegbahn, Hulthe, & Elmgren, 2008; Mattace-Raso et al., 2004).”
Background
Relationship between Impairment of the Vascular Endothelial Function and the CHA2DS2-VASc Score in Patients with Sinus Rhythm and Non-valvular Atrial Fibrillation
Komatsu, T., Kunugita, F., Ozawa, M., Satoh, Y., Yoshizawa, R., Owada, S., Sawa, Y., Morino, Y., & Nakamura, M. (2018) · Internal Medicine · doi:10.2169/internalmedicine.9831-17 · Cited by 19
“A previous study showed that the blood C-reactive protein values were related to endothelium-dependent vasodilatation, as chronic inflammation is related to the development of atherosclerosis (31).”
Background
Systemic High-sensitivity C-reactive Protein Levels in Normal-tension Glaucoma and Primary Open-angle Glaucoma
Su, W.-W., Ho, W., Cheng, S.-T., Chang, S. H. L., & Wu, S.-C. (2007) · Journal of Glaucoma · doi:10.1097/ijg.0b013e3180391a83 · Cited by 19
“CRP can induce an inflammatory reaction in the vascular endothelium and smooth muscle, thus elevated CRP level was associated with vascular endothelial dysfunction and plaque formation.(24,25) In glaucoma, although several reports have demonstrated an impaired vascular endothelial function in the patients with NTG, a…”
Background
Evaluation of Arterial Stiffness in Patients with Behçet's Disease by Using Noninvasive Radiological Methods such as Intima-Media Thickness of the Carotid, Ankle-Brachial Pressure Index, Coronary Artery Calcium Scoring, and Their Relation to Serum Fetuin-A Levels: A Case-Control Study
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Predictive value of high sensitivity C-reactive protein in three-vessel disease patients with and without type 2 diabetes
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Mildly Decreased Glomerular Filtration Rate Is Associated With Poor Coronary Collateral Circulation in Patients With Coronary Artery Disease
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Impaired Flow-Mediated Vasodilatation Is Associated With Increased Left Ventricular Mass in a Multiethnic Population. The Northern Manhattan Study
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High-sensitivity C-reactive protein and impaired coronary vasoreactivity in young men with uncomplicated type 1 diabetes
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“[90] It enhances local expression of multiple cell surface adhesion molecules thus playing a role in inflammation.”
Platelet and Monocyte Activation in Acute Ischemic Stroke—Is There a Correlation With Stroke Etiology?
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Background
Association between serum concentrations of nitric oxide and transition to menopause
Tehrani, F. R., Behboudi‐Gandevani, S., Ghasemi, A., & Azizi, F. (2015) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.12655 · Cited by 17
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Background
Long-term effects of pravastatin and fosinopril on peripheral endothelial function in albuminuric subjects
Asselbergs, F. W., van der Harst, P., van Roon, A. M., Hillege, H. L., de Jong, P. E., Gans, R. O. B., Smit, A. J., & van Gilst, W. H. (2006) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.11.011 · Cited by 17
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Placing PRINCE in Perspective
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Extreme occupational heat exposure is associated with elevated haematological and inflammatory markers in Fire Service Instructors
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Association of Fibrinogen/Albumin Ratio and Coronary Collateral Circulation in Stable Coronary Artery Disease Patients
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“There are a number of non-invasive methods that are used to evaluate endothelial function((50)).”
Method
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Type 2 diabetes mellitus is a risk factor for the development of hypertension in postmenopausal women
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Possible protective effect of serum β-carotene levels on the association between interleukin-1B C-31T polymorphism and hypertension in a Japanese population
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“Increased hsCRP levels due to inflammation lead to a risk for endothelial dysfunction [30] and cause progression of atherosclerosis and cardiovascular disease [31].”
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Analysis of C-Reactive Protein and Biochemical Parameters in Pericardial Fluid
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“Such a reaction can be in response to non-specific stimuli such as confounding risk factors, atherosclerosis, vascular injury, ischemia, and necrosis.(8-11) In patients with myocardial infarction, serum CRP levels rise and this increase can persist for more than 4 weeks.”
Background
Proportions of Proinflammatory Monocytes Are Important Predictors of Mortality Risk in Hemodialysis Patients
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Authors: Fichtlscherer, S., Rosenberger, G., Walter, D. H., Breuer, S., Dimmeler, S., & Zeiher, A. M.
Affiliations: Goethe University Frankfurt (DE)
ORCID: Walter, Dirk H.
Dimmeler, Stefanie
Zeiher, Andreas M.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2000-08-29
Volume: 102
Issue: 9
Pages: 1000-1006
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.102.9.1000
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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Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease

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