cqvip:Background and Purpose -The local renin-angiotensin system (RAS) and cycl ooxygenase-2 contribute to the activation of nuclear factor κ B(NFκ B) and C -reactive protein (CRP). We hypothesized that the combination of RAS blockers (RASb) and ASA reduces NFκ B and CRP within atherosclerotic plaques . Methods -Patients undergoing carotid endarterectomy were divided into groups according to treatment (RASb-acetylsalicylic acid [ASA], ASA, RASb, and contr ol). The expression of NFκ B, CRP, and CD40L was analyzed through Western blots in the obtained plaques. Results -Plaques from patients treated with the comb ination of RASb and ASA showed lower expression of NFκ B (25.4± 9.8 densitomet ric units [DU]) than those of the control group (57.6± 13.2 DU, P=0.03) as well as lower expression of CRP (20.9± 9.6 DU) than those of the other treatment gr oups (ASA 86.1± 13 DU, RASb 88.4± 31 DU, controls 67.8± 18.6, P=0.004). A neg ative expression of NFκ B was associated with a reduced incidence of symptoms c ompared with a positive expression (5/33 [15.1% ] versus 14/35 [40% ], P=0.031 ). Conclusions -The combined treatment with RASb and ASA decreases the express ion of inflammatory markers in atherosclerosis in humans. This study supports th e role of the local RAS and cyclooxygenase-2 in the progression of atheroscler osis.
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