Correlation Between High- sensitivity C-reactive Protein and Intima Media Thickness in Patients with Coronary Artery Diseases and Essential Hypertension

Cardiovascular diseases represent the major cause of mortality in Europe, both in females and males, and it refers to a large number of potentially fatal diseases including coronary artery diseases (CAD) and arterial hypertension [1]. CAD also known as ischemic heart disease, manifests in two major symptoms: angina and heart attack. The risk factors that can lead to CAD are well determined and include fixed risk factors such as age, family history, sex and modifiable risk factors that include smoking, hypertension, obesity, diabetes, hyperlipidaemia and stress. Atherosclerosis is considered a chronic inflammatory disease of the arterial system that plays a critical role in the CAD. Atherosclerosis is caused by the dysfunction of the endothelial wall due to the accumulation of lipoproteins in the intima of the coronary vessels and Further development of the atherosclerotic lesion will imply the formation of foam cells, the migration and proliferation of smooth muscle cells in the foamy cells with the consecutive appearance of the fibrous plaque that will decrease the arterial lumen and the advance to complicated lesion that can be thrombogenic. Inflammation plays a major role in the smooth muscle cell migration and proliferation [2]. Determination of intima media thickness (IMT) represents a non-invasive method used to assess the early arterial wall alteration of the carotid artery. The IMT measurements predict the cumulative effect of atherosclerotic risk factors correlated with de future cardiovascular risk [3]. Hypertension represents the central risk factor for the appearance of cardiovascular events. Blood flow vortex that appears in hypertension can produce irreversible damage to the arterial wall, leading to an accelerated development of atherosclerosis, therefore to the CAD events. A high blood pressure level can stimulate the inflammatory response, that is now known to play a central role in the pathogenesis of atherosclerosis [4]. It was found that high sensitivity C-reactive protein (hsCRP), a biomarker of low-grade inflammation that is produced in the liver in response to IL-6 secretion, can be a predictor for cardiovascular events [5]. hsCRP was found also in the endothelium cells of the atherosclerotic lesions and it was proposed that hsCRP can stimulate the inflammatory reaction of arteriosclerosis by increasing the cell adhesion in vascular endothelial cells, idea that lead to the hypothesis that CRP could be a target for the arteriosclerosis treatment [6]. The aim of the study was to assess the relationship between hsCRP and IMT in patients with CAD and hypertension, to evaluate the predictive value of hsCRP and IMT for future cardiovascular events.