Both cyclooxygenase- and cytokine-mediated inflammation are associated with carotid intima–media thickness

Background. Common carotid artery intima–media thickness (CCA-IMT) is a valid index of atherosclerosis, which is viewed as an inflammatory disease. It is unknown if various modes of inflammation (cyclooxygenase [COX]-mediated, cytokine-mediated), oxidative stress and anti-oxidants are independently related to CCA-IMT. Methods and results. We investigated cross-sectional relations between CCA-IMT measured by B-mode ultrasound and COX-mediated inflammation (as measured by 15-keto-dihydro-prostaglandin F2α [PGF2α], cytokine-mediated inflammation (interleukin-6 [IL-6], high sensitivity C-reactive protein [hsCRP] and serum amyloid A protein [SAA]), oxidative stress (8-iso-PGF2α, an F2-isoprostane; a non-enzymatic, free radical-induced product of arachidonic acid), and tocopherols (anti-oxidants) in a small subset of a population-based sample of elderly men (n = 234) stating no use of anti-inflammatory medications. In a backward-stepwise regression analysis of correlates of CCA-IMT (with PGF2α, hsCRP, IL-6, SAA, F2-isoprostanes, tocopherols, diabetes, body mass index (BMI), β-blocker, statin treatment, smoking, hypertension and cholesterol), PGF2α, CRP, β-blocker treatment, diabetes and BMI were independently associated with CCA-IMT. There were no associations between F2-isoprostanes or tocopherols and CCA-IMT in this study. Conclusion. This study suggests both COX- and cytokine-mediated inflammation to be independently associated with increased CCA-IMT, implying that there might be more than one mode of inflammation involved in atherogenesis.