Inflmmn nd Cd Ay Rk f Ahcl Sudy Ech Mn Mdcl Unvy Vnn Dpmn Anglgy TCT 2005; Ocb 2005, Whngn
Pn Dclu Infmn Nm: Mn Ech Nhng dcl
Bckgund Sk h hd-ldng cu f dh nd h m cmmn cu f pmnn dbly. Lg-y hmbmblm gnng fm hcl n h cd ccun f 30% f h vn. Rcnly, ubnlly ncd k f nulgcl vn w nd n pn wh pd pgn f hclc ln n h cd, wh 2-y k xcdng 10% (Bg l; Ach Inn Md 2003;163:2285). Pdcn f h k f pgn f cd hcl, hwv, mn mj unlvd u.
Bckgund nd Hyph
Bckgund nd Hyph Ahcl n nflmmy d? Th xn f vcul nflmmn flc h cvy f h d nd h lklhd f plqu pgn? Acu ph pm qunfyng h xn f nflmmn my pdc pgn f cd n
Sudy Am T dmn whh h xn f nflmmn mud by cu ph pm hw mpl cn wh mphlgcl pgn f cd hcl. T dmn whh nflmmn nd pgn f cd d pdc cbvcul vn.
Sudy Endpn Mphlgcl ndpn. Pgn f hcl by ulund - nc >20% - chng f PSV bln fllw-up Clncl ndpn. Ipll nulgcl vn (TIA, ny k)
Db Ppcv ch udy 03/2002 03/2003 1268 cncuv pn undgng DUS f upcd ICA hcl - cd bu - hclc d n h vl ( cny, pphl) - chduld f mj cdc ugy Cdvcul k fc / cmbd Fllw-up 6-9 mnh: - pd cd ulund - vlun f nulgcl vn
Agmn DUS v. Anggphy Anggphc Dg f Sn (NASCET) 100% 80% 60% 40% 20% 0% Cd (n=) (205) 0 29% 2=0.66 p<0.001 (112) 30 49% (111) (525) 50 69% 70 99% (53) 100% Duplx Dg f Sn Rdlgy 2004; 232: 431-439
Agmn DUS v. Anggphy Anggphc Dg f Sn (NASCET) 100% nd u ) d l u x nd 60% l p u ld D n g. ( d y w n h u u p b 40% mn ngg uly n l u. lx g d v p n u 20% n) D p n d l l c p x d d E n mn =0.66 y d c u p<0.001 d0% 1006 ( n b n(n=) (205) (112) Cd (111) (525) (53) y h 0 29% 30 49% 50 69% 70 99% 100% b l Duplx Dg f Sn 80% 2 Rdlgy 2004; 232: 431-439
Evn Fllw up (x 7.5 [6-9] mnh) Sn pgn D-nv cclun Nu-vn 103 (8.1%) 8 (0.6%) 15 (1.2%)
Inflmmn nd D Pgn h C-cv Pn bln Fdm fm D Pgn (%) 100 qunl 1 90 80 qunl 2 70 qunl 3 qunl 4 60 qunl 5 Lg Rnk p<0.001 50 n=1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh) Cculn 2005;111: 2203-09
Inflmmn nd D Pgn Sum Amyd A Bln Fdm fm D Pgn (%) 100 90 qunl 1 80 qunl 2 qunl 3 qunl 4 70 qunl 5 60 Lg Rnk p<0.001 50 n=1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh) Cculn 2005;111: 2203-09
Inflmmn nd D Pgn 100 Fdm fm D Pgn (%) h w d. c n S d n C m n f m l f n I g P qunl 1 90 80 qunl 2 70 qunl 3 qunl 4 60 qunl 5 Lg Rnk p<0.001 50 n=1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh)
Fbngn Fbngn ply pvl l n h nl ph nd h dvncd g f hcl. Lg ppuln-bd ud uch h Cpnhgn cy udy (N=8755) nd h Ghnbug Sudy (N=792) unquvclly dmnd n ncng k f fuu k wh ncng lvl f fbngn, Plqu cmpn f pn wh lvd fbngn lvl chczd by h pnc f hgh numb f nflmmy cll lclzd mnly n h huld nd n h cp f h plqu. (Mull l; Cculn 2000;101:744 750)
Sk 2005;36:1400-1404
Inflmmn, Dg f Sn nd D Pgn 100 Fdm fm D Pgn (%) bln bln ICA<50% lw SAA 90 ICA<50% lw CRP ICA<50% hgh SAA ICA<50% hgh CRP 80 ICA>50% lw SAA 70 ICA>50% lw CRP 60 Lg Rnk p<0.001 Lg Rnk p<0.001 ICA>50% hgh SAA ICA>50% hgh CRP 50 n=1268 0 1261 3 1173 449 200 102 63 6 9 12 15 18 Fllw-up Tm (Mnh) 1268 0 1261 3 1173 449 200 102 63 6 9 12 15 18 Fllw-up Tm (Mnh) Cculn 2005;111: 2203-09
Inflmmn, Dg f Sn nd D Pgn bln RISK FOR PROGRESSION OF ATHEROSCLEROSIS ICA<50% + lw h-crp (n=478) 1.0 ICA<50% + hgh h-crp (n=281) 3.13 (1.70 5.75) ICA>50% + lw h-crp (n=302) 4.05 (1.60 6.89) ICA>50% + hgh h-crp (n=207) 6.07 (2.21 10.21) ICA<50% + lw SAA (n=349) 1.0 ICA<50% + hgh SAA (n=411) 1.96 (1.06 3.62) ICA>50% + lw SAA (n=321) 3.13 (1.09 5.19) ICA>50% + hgh SAA (n=187) 4.04 (1.74 6.69) 0,1 1 10 100 ADJUSTED HAZARD RATIO (95% CI) Cculn 2005;111: 2203-09
Nulgcl Evn Fdm fm chmc Nulgcl Evn (%) 100 98% 98 Pn whu 96% pgv cd d 96 95% 94 92 91% Lg Rnk p=0.011 90 n=1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh) Pn wh pgv cd d
Nulgcl Evn 100 Fdm fm chmc Nulgcl Evn (%) 98% 98 n. S k A C I S f n f c g F P Rk Pn whu 96% pgv cd d 96 95% 94 92 91% Lg Rnk p=0.011 90 n=1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh) Pn wh pgv cd d
Inflmmn, Dg f Sn nd Nulgcl Evn 100 ICA<50% lw SAA Fdm fm chmc Nulgcl Evn (%) ICA<50% lw CRP ICA<50% hgh SAA ICA<50% hgh CRP 98 96 ICA>50% lw SAA ICA>50% lw CRP 94 92 Lg Rnk p=0.020 Lg Rnk p<0.001 90 ICA>50% hgh SAA ICA>50% hgh CRP n=1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh) 1268 0 1261 1173 449 200 102 63 3 6 9 12 15 18 Fllw-up Tm (Mnh) Cculn 2005;111: 2203-09
Inflmmn, Dg f Sn nd Nulgcl Evn RISK FOR NEUROLOGICAL EVENTS ICA<50% + lw h-crp (n=478) 1.0 ICA<50% + hgh h-crp (n=281) 5.61 (0.61 51.63) ICA>50% + lw h-crp (n=302) 8.27 (0.90 75.99) ICA>50% + hgh h-crp (n=207) 14.93 (1.83 121.56) ICA<50% + lw SAA (n=349) 1.0 ICA<50% + hgh SAA (n=411) 3.57 (0.31 41.12) ICA>50% + lw SAA (n=321) 7.30 (0.87 61.08) ICA>50% + hgh SAA (n=187) 10.71 (1.26 90.45) 0,1 1 10 100 ADJUSTED HAZARD RATIO (95% CI) Cculn 2005;111: 2203-09
Inflmmn, Dg f Sn nd Nulgcl Evn RISK FOR NEUROLOGICAL EVENTS ICA<50% + lw h-crp (n=478) 1.0 ICA<50% + hgh h-crp (n=281) 5.61 (0.61 51.63) ICA>50% + lw h-crp (n=302) 8.27 (0.90 75.99) ICA>50% + hgh h-crp (n=207) 14.93 (1.83 121.56) ICA<50% + lw SAA (n=349) 1.0 ICA<50% + hgh SAA (n=411) 3.57 (0.31 41.12) ICA>50% + lw SAA (n=321) 7.30 (0.87 61.08) ICA>50% + hgh SAA (n=187) 10.71 (1.26 90.45) l C dd n. n c d m P m k l f n R I 0,1 1 l c n 10 100 ADJUSTED HAZARD RATIO (95% CI)
Cnclun Inflmmn cd wh d pgn n hclc cd. Inflmmn dd clncl k pdcn f nulgcl vn.