Increased level of inflammatory biomarkers and carotid plaque burden associated with persistent asthma: JAHA

In comparison to participants without asthma, those with persistent asthma had higher levels of inflammatory biomarkers and a higher burden of carotid plaque, says an article published in the Journal of the American Heart Association.

The fundamental pathophysiology of both asthma and atherosclerotic cardiovascular disease is inflammation. According to Matthew Tattersall and colleagues, carotid plaque load, a significant predictor of atherosclerotic cardiovascular disease events, is linked to chronic asthma.

Adults without known atherosclerotic cardiovascular disease were included in the MESA (Multi-Ethnic Study of Atherosclerosis). At exam 1, the subtype of asthma was identified. Intermittent asthma is asthma that doesn't require the use of controller drugs, whereas persistent asthma is asthma that does. To find carotid plaques, B-mode carotid ultrasonography was used (total plaque score [TPS], range 0–12). The relationship between the prevalence of carotid plaque and the subtype of asthma was assessed using multivariable regression modeling with robust variances.

The key findings of this study were:

1. The mean (SD) age of the 5029 participants was 61.6 (10.0) years; 53% of participants were female; 26% of participants were Black; 23% of participants were Hispanic; and 12% of participants were Chinese.

2. 50.5% of individuals had carotid plaque (TPS, 1.29 [1.80]), 49.5% had intermittent asthma (TPS, 1.25 [1.76]), and 67% had chronic asthma (TPS, 2.08 [2.35]).

3. Interleukin-6 levels were greater in persons with chronic asthma (1.89 [1.61] pg/mL) compared to those without asthma (1.52 [1.21] pg/mL; P=0.02).

4. After adjusting for baseline interleukin-6 and CRP (C- Reactive Protein) levels, persistent asthma was still linked with carotid plaque presence and TPS in fully adjusted models.

In comparison to patients without asthma, participants with chronic asthma had a greater carotid plaque load, but not participants with intermittent asthma. Participants who had persistent asthma also had higher levels of inflammatory biomarkers, but controlling for baseline inflammatory biomarkers did not weaken the link between carotid plaque and asthma subtype, suggesting that the increased asthma and atherosclerotic cardiovascular disease (ASCVD) risk in people with persistent asthma may be multifactorial.

Reference: 

Tattersall, M. C., Dasiewicz, A. S., McClelland, R. L., Jarjour, N. N., Korcarz, C. E., Mitchell, C. C., Esnault, S., Szklo, M., & Stein, J. H. (2022). Persistent Asthma Is Associated With Carotid Plaque in MESA. In Journal of the American Heart Association. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/jaha.122.026644