Asymptomatic carotid plaque and pro-inflammatory genetic profile in the elderly

Background and aims: Several indices of subclinical atherosclerosis (ATS), including ultrasound (US) scan of carotid vessels, have received attention in clinical studies of the general population. Since inflammation takes part in the development of ATS, we studied the relationship between US imaging of carotid vessels and genetic predisposition to inflammation, in both elderly subjects without acknowledged CV risk factors and elderly subjects with acknowledged CV risk factors undergoing primary prevention. Methods: Seventy-two elderly subjects (aged between 65-84) were divided into three groups on the basis of cardiovascular (CV) risk (GO: 0-9%, G1: 10-20% and G2: >20%) according to the NCEP Adult Panel III Report. They underwent US evaluation of carotid arteries and were analyzed for single nucleotide polymorphisms in the genes of a number of cytokines: TNF-alpha TGF-beta 1, IL-10, IL-6 and IFN-gamma. Results: Asymptomatic carotid plaque (ACP) was detected in 19 subjects, not only in those belonging to the major risk group (36.8%) but also in those at lower risk (63.2%). In these subjects, we found a different genotype distribution in the polymorphisms of IFN-gamma (+874), IL-6 (-174) and IL-10 (-1082). The TT +874 IFN-gamma and GG -174 IL-6 high producer-genotypes and the AA IL-10 low producer-genotype were indeed more frequent in the ACP group (IFN-gamma. p=0.000 and IL-6: p=0.004). We found no correlation between genotype and carotid intima-media thickening. Conclusions: Our data suggest that, in the elderly, inflammation-associated polymorphisms are related to atherogenesis and that the finding of ACP on US scan can be valuable in identifying subjects at risk for CV events, even if they lack traditional cardiovascular risk factors such as an increase in IMT.