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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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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