Variance in biomarker usefulness as indicators for carotid and coronary atherosclerosis

Background: Atherosclerosis is a systemic disease. Nevertheless, the role of specific biomarkers as indicators for both coronary and carotid diseases is debatable. Objectives: To evaluate the association of biomarkers with coronary and carotid disease. Methods: We studied 522 consecutive patients with stable angina. All underwent coronary angiography and carotid duplex study on the same day. Patients with no apparent carotid plaques were evaluated for carotid intima-media thickness (CIMT) using an automated system that sampled over 100 samples in each carotid artery. Biochemical markers of cardiovascular disease risk were obtained at the time of coronary angiography, including serum lipid levels, hemoglobin A1C (HbA1c), white blood cell count, fibrinogen and high sensitivity Creactive protein (hs-CRP). Results: The mean age of the patients was 66± 11; 73% were males. Significant carotid stenosis was associated with higher hs-CRP (9.4± 17 vs. 6.3± 13 mg/L, P = 0.001), while high HbA1c (6.7± 1.6 vs. 5.8± 0.8%, P < 0.001) and low high density lipoprotein levels (40± 9 vs. 47± 14 mg/dl, P < 0.001) were linked with advanced coronary artery disease severity. In contrast, CIMT was not related to any of the biomarkers evaluated. Conclusions: Although atherosclerosis is considered a systemic disease, different biomarkers are associated with coronary and carotid artery disease. Identifying the specific biomarkers for each disease is important for both prevention and for exposing the underlying pathophysiologic mechanism.