Inflammatory Markers and Carotid Intima Media Thickness (C-IMT) in Stable IHD Patients

Objectives: -to explore the role of a cohort of soluble markers among them and in relation to C-IMT changes in a two years follow-up; -to evaluate the effect of a two years moderate dose atorvastatin treatment on time modifications both of markers and C-IMT. Methods: MIAMI is an open, multicenter, independent study. 86 stable IHD patients, were scheduled to receive atorvastatin (20 mg/daily) for 24 months. VCAM, ICAM, E-selectins, IL-6, -8, -10, -18, TNF-, hs-CRP, MMP-9, TF, TFPI, CD40-L, vWF, Fg, TC, HDL, LDL, TG, urinary isoprostanes were measured at 0, 12 and 24 months, in parallel with C-IMT measured blindly by computerised determination. Results: TC and LDL levels were at upper limits, whereas HDL and TG were normal. Levels of markers did not significantly correlate with traditional risk factors. HDL was negatively correlated with ICAM-1 (p<0.0001), sVCAM-1 p<0.05), E-selectin (p<0.05), hs-CRP (p<0.05), IL-6 (p<0.059), whereas TG positively correlated with sICAM-1 (p<0.001), E-selectin (p<0.05), TF (p<0.05), TFPI (p<0.05) and CD40-L (p<0.05). Mean IMT was at upper limits (0.89 ± 0.18 mm). C-IMT values were strictly and independently correlated with age. At univariate analysis after adjustement for relevant co-variates, E-selectin and TFPI were strongly correlated with IMT values at different carotid sites. Also hs-CRP and IL-6 were positively associated with CC-IMT mean and mean IMT, respectively. The multivariate analysis confirmed the association of E-selectin and TFPI with multiple IMT parameters, and the correlation between hs-CRP and CC-IMT mean. Conclusions: Baseline data show a strong correlation between E-selectin and TFPI and C-IMT at different sites in patients with stable IHD. The significance of these findings, the role of other markers and their association with IMT changes will be the object of final analysis of the study, as well as the assessment of atorvastatin effects.