Inflammatory response after influenza vaccination in men with and without carotid artery disease

Objective - Inflammatory markers are associated with vascular disease; however, variation in the acute phase response (APR) has not been evaluated. We evaluated whether the APR magnitude in men with severe carotid artery disease (CAAD) (> 80% stenosis) differed from that of men without stenosis (< 15% stenosis). Methods and Results - White males with (n = 43) and without (n = 61) severe CAAD receiving clinical influenza vaccinations were recruited. Their baseline and 24-hour after - vaccination blood samples were assayed for C-reactive protein (CRP), IL-6, and serum amyloid-a (SAA). In vivo APR to vaccination was measurable and varied among subjects. Adjusted for age, smoking, oral hypoglycemics, aspirin, and stain use, the relative 24-hour changes in levels of 1n(CRP), 1n( IL-6), and 1n(SAA) were higher in men with CAAD than in men without, but only the SAA response was significant (P = 0.02); the relative SAA response was 1.6 (95% confidence interval, 1.1 to 2.5) times higher in men with than without CAAD. The APR for all markers appeared to be independent of baseline levels. Conclusions - Influenza vaccination results in a mild, but measurable, APR in men with and without CAAD. SAA APR variability may be a predictor of severe vascular disease that is independent of basal SAA level.