Eosinophil Cationic Protein, Carotid Plaque, and Incidence of Stroke

• Published in: Stroke (1970) Vol. 48; no. 10; pp. 2686 - 2692
• Main Authors: Sundström, Johannes, Söderholm, Martin, Borné, Yan, Nilsson, Jan, Persson, Margaretha, Östling, Gerd, Melander, Olle, Orho-Melander, Marju, Engström, Gunnar
• Format: Journal Article
• Language: English
• Published: United States American Heart Association, Inc 01.10.2017
• Subjects: Biomarkers - blood; Brain Ischemia - blood; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Cardiology and Cardiovascular Disease; Carotid Artery Diseases - blood; Carotid Artery Diseases - diagnosis; Carotid Artery Diseases - epidemiology; Clinical Medicine; Cohort Studies; Eosinophil Cationic Protein - blood; Female; Follow-Up Studies; Humans; Incidence; Kardiologi och kardiovaskulära sjukdomar; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Plaque, Atherosclerotic - blood; Plaque, Atherosclerotic - diagnosis; Plaque, Atherosclerotic - epidemiology; Population Surveillance - methods; Prospective Studies; Stroke - blood; Stroke - diagnosis; Stroke - epidemiology; Sweden - epidemiology; cohort studies; epidemiology; eosinophil cationic protein; risk factors; stroke
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/STROKEAHA.117.018450

BACKGROUND AND PURPOSE—ECP (eosinophil cationic protein) is a marker of eosinophil activity and degranulation, which has been linked to atherosclerosis and cardiovascular disease. We examined the relationship between ECP, carotid plaque, and incidence of stroke in a prospective population-based cohort. METHODS—The subjects participated in the Malmö Diet and Cancer Study between 1991 and 1994. A total of 4706 subjects with no history of stroke were included (40% men; mean age, 57.5 years). Carotid plaque was determined by B-mode ultrasound of the right carotid artery. Incidence of stroke was followed up during a mean period of 16.5 years in relation to plasma ECP levels. RESULTS—Subjects in the third tertile (versus first tertile) of ECP tended to have higher prevalence of carotid plaque (odds ratio1.18; 95% confidence interval1.003–1.39; P=0.044 after multivariate adjustments). A total of 258 subjects were diagnosed with ischemic stroke (IS) during follow-up. ECP was associated with increased incidence of IS after risk factor adjustment (hazard ratio, 1.57; 95% confidence interval1.13–2.18; for third versus first tertile; P=0.007). High ECP was associated with increased risk of IS in subjects with carotid plaque. The risk factor–adjusted hazard ratio for IS was 1.86 (95% confidence interval1.32–2.63) in subjects with carotid plaque and ECP in the top tertile, compared with those without plaque and ECP in the first or second tertiles. CONCLUSIONS—High ECP is associated with increased incidence of IS. The association between ECP and IS was also present in the subgroup with carotid plaque.