Abstract
Purpose
To determine C-reactive protein (CRP) levels in acute retinal artery occlusion (RAO) and their association with atherosclerotic risk factors.
Methods
CRP levels in 16 patients with RAO were compared with levels in 16 age-matched controls at risk of atherosclerosis and 16 young volunteers. Repeated CRP testing was performed 6 years later.
Results
Elevated CRP levels (>3 mg/l) and risk factors for atherosclerosis were detected in seven patients in the study group (44%) and nine at-risk controls (56%). On follow-up, CRP levels were reduced in all seven retested patients. Six patients died of vascular events within 5 years, of whom four had high CRP levels during RAO.
Conclusions
CRP level correlates with atherosclerosis but it is not significantly elevated in patients with RAO.
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References
Ross R . Atherosclerosis is an inflammatory disease. Am Heart J 1999a; 138: S419–S420.
Blum A, Miller HI . The role of inflammation in atherosclerosis. Isr J Med Sci 1996; 32: 1059–1065.
Ludewig B, Zinkernagel RM, Hengartner H . Arterial inflammation and atherosclerosis. Trends Cardiovasc Med 2002; 12: 154–159.
Williams KJ, Tabas I . Atherosclerosis and inflammation. Science 2002; 297: 521–522.
Farmer JA, Torre-Amione G . Atherosclerosis and inflammation. Curr Atheroscler Rep 2002; 4: 92–98.
Ross R . Atherosclerosis—an inflammatory disease. N Engl J Med 1999b; 340: 115–126.
Bhakdi S . Pathogenesis of atherosclerosis: infection versus immune pathogenesis. A new concept. Herz 2000; 25: 84–86.
Maseri A . Inflammation, atherosclerosis, and ischemic events—exploring the hidden side of the mood. N Engl J Med 1997; 336: 1014–1016.
Cleland SJ, Sattar N, Petrie JR, Forouhi NG, Elliott HL, Connell JM . Endothelial dysfunction as a possible link between C-reactive protein levels and cardiovascular disease. Clin Sci (Colch) 2000; 98: 531–535.
Du Clos TW . Function of C-reactive protein. Ann Med 2000; 32: 274–278.
Ohzato H, Yoshizaki K, Nishimoto N, Ogata A, Tagoh H, Monden M et al. Interleukin-6 as a new indicator of inflammatory status: detection of serum levels of interleukin-6 and C-reactive protein after surgery. Surgery 1992; 111: 201–209.
Gabay C, Kushner L . Acute phase proteins and other systemic responses to inflammation. N Engl J Med 1999; 340: 448–454.
de Beer FC, Hind CR, Fox KM, Allan RM, Maseri A, Pepys MB . Measurement of C-reactive protein concentration in myocardial ischemia and infarction. Br Heart J 1982; 47: 239–243.
Liuzzo G, Baisucci LM, Gallimore JR, Caligiuri G, Buffon A, Rebuzzi AG et al. Enhanced inflammatory response in patients with preinfarction unstable angina. J Am Coll Cardiol 1999; 34: 1696–1703.
Fichtlscherer S, Rosenberger G, Walter DH, Breuer S, Dimmeler S, Zeiher AM . Elevated C-reactive protein levels and impaired endothelial vasoreactivity in patients with coronary artery disease. Circulation 2000; 102: 1000–1006.
Ridker PM . C-reactive protein and risks of future myocardial infarction and thrombotic stroke. Eur Heart J 1998; 19: 1–3.
Ridker PM, Glynn RJ, Hennekens CH . C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction. Circulation 1998b; 97: 2007–2011.
Wijns W, Ribichini F . CRP: does it stand for coronary restenosis prediction? Eur Heart J 2000; 21: 1121–1123.
Gussekloo J, Schaap MC, Frölich M, Blauw GJ, Westendorp RG . C-reactive protein is a strong but nonspecific risk factor of fatal stroke in elderly persons. Arterioscler Thromb Vasc Biol 2000; 20: 1047–1051.
Lindahl B, Toss H, Siegbahn A, Venge P, Wallentin L . Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. FRISC Study Group. Fragmin during instability in coronary artery disease. N Engl J Med 2000; 343: 1139–1147.
Majewski W, Laciak M, Staniszewski R, Górny A, Mackiewicz A . C-reactive protein and alpha-1-acid glycoprotein in monitoring of patients with acute arterial occlusion. Eur J Vasc Surg 1991; 5: 641–645.
Majewski W, Zielinski A, Laciak M, Staniszewski R, Górny A, Zapalski S et al. C-reactive protein and alpha-1-acid glycoprotein in monitoring of patients with chronic arterial occlusion of the lower limbs. Eur J Vasc Surg 1993; 7: 628–632.
Blann Ad, Ridker PM, Lip GY . Inflammation, cell adhesion molecules, and stroke: tools in pathophysiology and epidemiology? Stroke 2002; 33: 2141–2143.
Kinlay S, Egido J . Inflammatory biomarkers in stable atherosclerosis. Am J Cardiol 2006; 4, 98 2P–8P.
Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH . Inflammation, aspirin and the risk of cardiovascular disease in apparently healthy men. N Eng J Med 1997; 336: 973–979.
Blaschke F, Bruemmer D, Yin F, Takata Y, Wang W, Fishbein MC et al. C-reactive protein induces apoptosis in human coronary vascular smooth muscle cells. Circulation 2004; 110: 579–587.
Kimura K, Hashimoto Y, Ohno H, Uchino M, Ando M . Carotid artery disease in patients with retinal artery occlusion. Intern Med 1996; 35: 937–940.
Kramer M, Goldenberg-Cohen N, Shapira Y, Axer-Siegel R, Shmuely H, Adler Y et al. Role of transesophageal echocardiography in the evaluation of patients with retinal artery occlusion. Ophthalmology 2001; 108: 1461–1464.
Kinlay S, Timms T, Clark M, Karam C, Bilodeau T, Ridker PM et al. Comparison of effect of intensive lipid lowering with atorvastatin to less intensive lowering with lovastatin on C-reactive protein in patients with stable angina and inducible myocardial ischemia. Am J Cardiol 2002; 89: 1205–1207.
Foroozan R, Savino PJ, Sergott RC . Embolic central retinal artery occlusion detected by orbital color Doppler imaging. Ophthalmology 2002; 109: 744–747. (Discussion 747–748).
Larsson J . Central retinal artery occlusion in a patient homozygous for factor V Leiden. Am J Ophthalmol 2000; 129: 816–817.
Greven CM, Slusher MM, Weaver RG . Retinal artery occlusion in young adults. Am J Ophthalmol 1995; 120: 776–783.
Kramer M, Goldenberg-Cohen N, Axer-Siegel R, Weinberger D, Cohen Y, Monselise Y . Inflammatory reaction in acute retinal artery occlusion: cytokine levels in aqueous humor and serum ocular immunology and inflammation. Occul Immunol Inflamm 2005; 13: 305–310.
Seddon JM, Gensler G, Milton RC, Klein ML, Rifai N . Association between C-reactive protein and age-related macular degeneration. JAMA 2004; 291: 704–710.
Vine AK, Stader J, Branham K, Musch DC, Swaroop A . Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology 2005; 112: 2076–2080.
Seddon JM, George S, Rosner B, Rifai N . Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin-6, and other cardiovascular biomarkers. Arch Ophthalmol 2005; 123: 774–782.
Dasch B, Fuhs A, Behrens T, Meister A, Wellmann J, Fobker M et al. Inflammatory markers in age-related maculopathy: cross-sectional analysis from the Muenster Aging and Retina Study. Arch Ophthalmol 2005; 123: 1501–1506.
McGwin G, Hall TA, Xie A, Owsley C . The relation between C-reactive protein and age-related macular degeneration in the Cardiovascular Health Study. Br J Ophthalmol 2005; 89: 1166–1170.
Parikh M, Miller NR, Lee AG, Savino PJ, Vacarezza MN, Cornblath W et al. Prevalence of a normal C-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis. Ophthalmology 2006; 113: 1842–1845.
Costello F, Zimmerman MB, Podhajsky PA, Hayreh SS . Role of thrombocytosis in diagnosis of giant cell arteritis and differentiation of arteritic and non-arteritic anterior ischemic optic neuropathy. Eur J Ophthalmol 2004; 14: 245–257.
Dodson PM, Shine B . Retinal vein occlusion: C-reactive protein and arterial hypertension. Acta Ophthalmol (Copenh) 1984; 62: 123–130.
Lee HB, Pulido JS, McCannel CA, Buettner H . Role of inflammation in retinal vein occlusion. Can J Ophthalmol 2007; 42: 131–133.
Leibovitch I, Kurtz S, Kesler A, Feithliher N, Shemesh G, Sela BA . C-reactive protein levels in normal tension glaucoma. J Glaucoma 2005; 14: 384–386.
Cao JJ, Arnold AM, Manolio TA, Polak JF, Psaty BM, Hirsch CH et al. Association of carotid artery intima-media thickness, plaques, and C-reactive protein with future cardiovascular disease and all-cause mortality: the Cardiovascular Health Study. Circulation 2007; 3, 116 32–38.
Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH . Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation 1998a; 97: 425–428.
Ridker PM . Inflammation, atherosclerosis, and cardiovascular risk: an epidemiologic view. Blood Coagul Fibrinolysis 1999; 10 (suppl 1): S9–S12.
Ridker PM, Hennekens CH, Buring JE, Rifai N . C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000a; 342: 836–843.
Fiotti N, Giansante C, Ponte E, Delbello C, Calabrese S, Zacchi T et al. Atherosclerosis and inflammation. Patterns of cytokine regulation in patients with peripheral arterial disease. Atherosclerosis 1999; 145: 51–60.
Mosca L . C-reactive protein—to screen or not to screen? N Engl J Med 2002; 347: 1615–1617.
Ridker PM, Rifai N, Stampfer MJ, Hennekens CH . Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation 2000b; 101: 1767–1772.
De Potter P, Zografos L . Survival prognosis of patients with retinal artery occlusion and associated carotid artery disease. Graefe's Arch Clin Exp Ophthalmol 1993; 231: 212–216.
Tomoda H, Aoki N . Prognostic value of C-reactive protein levels within six hours after the onset of acute myocardial infarction. Am Heart J 2000; 140: 324–328.
Acknowledgements
This study was presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), Fort Lauderdale, FL, USA, 2001; Abstract no. 3064; supported by the Ernest and Nusia Gothalf Fund, Tel Aviv University, 1998. We thank Ms. Dorit Karesh for the statistical analysis and Gloria Ginzach, Marian Propp and Melanie Kawe for their editorial and secretarial assistance.
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Goldenberg-Cohen, N., Cohen, Y., Monselise, Y. et al. C-reactive protein levels do not correlate with retinal artery occlusion but with atherosclerosis. Eye 23, 785–790 (2009). https://doi.org/10.1038/eye.2008.159
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DOI: https://doi.org/10.1038/eye.2008.159


