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(Circulation. 2002;105:e9111.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

Inflammation-Sensitive Proteins: Another Ingredient in Stroke?

When Swedish researchers monitored >6000 men for nearly 20 years after measuring levels of cholesterol and 5 inflammation-sensitive plasma proteins (fibrinogen, A1-antitrypsin, haptoglovin, ceruloplasmin, and orosomucoid), they found that high levels of these compounds were associated with hypercholesterolemia, increasing the risk of cardiovascular diseases. A report of their work appears in this week’s issue of Circulation (Circulation. 2002;105:2632–2637).

Defining high levels of inflammation-sensitive plasma proteins as levels of at least 2 in the upper quartile, the researchers, led by Gunnar Engström, MD, PhD, of the University of Malmo in Sweden, found that hypercholesterolemia was associated with an increased incidence of ischemic stroke, cardiac events, and reduced incidence of intracerebral hemorrhage in these groups. However, they also discovered that levels of inflammation-sensitive proteins changed this association. Men with hypercholesterolemia and high levels of inflammation-sensitive proteins had a significantly higher risk of ischemic stroke and cardiovascular mortality and events than did men with normal levels of cholesterol and inflammation-sensitive proteins. When the levels of inflammation-sensitive proteins were not high, hypercholesterolemia was associated with a moderately high risk of cardiovascular death and events, but not with ischemic stroke. They concluded that hypercholesterolemia is associated with high levels of the inflammation-sensitive proteins, which increase cholesterol-related incidence of ischemic stroke and heart attack.

In an accompanying editorial (Circulation. 2002;105:2583–2585), Paul M. Ridker, MD, MPH, of The Brigham and Women’s Hospital and Harvard Medical School in Boston, noted, "A central paradox of the cholesterol hypothesis is that long-term treatment with statins reduces . . . [Full Text of this Article]