Inflammatory markers and progression of subclinical atherosclerosis in healthy postmenopausal women (from the Estrogen in the Prevention of Atherosclerosis Trial).

Description

The purpose of this 2-year randomized controlled trial was to determine whether high-sensitive C-reactive protein (hs-CRP) and serum soluble intercellular adhesion molecule-1 (sICAM-1) correlate with progression of subclinical atherosclerosis. The authors also explored the long-term effects of oral 17β-estradiol (1 mg/day) vs. placebo on plasma levels of these inflammatory markers. Data from 180 healthy postmenopausal women (45 to 80 years of age) showed that there was no association between changes in hs-CRP and sICAM-1 and changes in carotid artery intima-media thickness (CIMT) during the trial period. Moreover, oral unopposed 17β-estradiol significantly increased plasma hs-CRP and decreased sICAM-1 compared to placebo. However, the authors noted that the 2-year trial might not have been long enough and that they may not have had sufficient statistical power to detect hs-CRP and sICAM-1 associations with CIMT progression. Additional studies on the effect of oral estrogen-induced increase in hs-CRP on plaque rupture are warranted.