Association Between Inflammatory Markers and Cognitive Impairment in Patients with Asymptomatic Carotid Stenosis


  • Elena Joveva Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia; Clinical Hospital of Stip, Stip, North Macedonia image/svg+xml
  • Marija Karakolevska-Ilova Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia; Clinical Hospital of Stip, Stip, North Macedonia image/svg+xml
  • Marijan Jovev Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia; Clinical Hospital of Stip, Stip, North Macedonia
  • Stefan Petrovski Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia; Clinical Hospital of Stip, Stip, North Macedonia image/svg+xml
  • Aleksandar Serafimov Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia; Clinical Hospital of Stip, Stip, North Macedonia
  • Marija Dimitrovska-Ivanova Faculty of Medical Sciences, University Goce Delcev, Stip, North Macedonia; Clinical Hospital of Stip, Stip, North Macedonia image/svg+xml



carotid stenosis, inflammatory markers, cognitive impairment


BACKGROUND: Certain inflammatory mechanisms are involved in the carotid atherosclerotic process, and determining the inflammatory activation can be useful in the assessment of cognitive impairment in patients with asymptomatic carotid stenosis (ACS).

AIM: This study aimed to correlate these markers of inflammation with the degree of asymptomatic carotid stenosis (ACS) and the degree of cognitive impairment.

MATERIALS AND METHODS: One hundred and twenty patients with carotid stenosis and 60 patients without carotid stenosis were enrolled in the study. Clinical, neurological, and laboratory evaluations (C-reactive protein [CRP], fibrinogen, tumor necrosis factor alpha [TNF-α]) were performed, as well as evaluation of intima-media thickness (IMT) and carotid stenosis degree. Cognitive functions were assessed with the Addenbrooke’s Cognitive Examination test. Neuroimaging tests were included.

RESULTS: There was no significant correlation in the asymptomatic group between TNFα and IMT and between fibrinogen, CRP, and IMT both on the left and the right side. In the same group, there was a statistically significant association between the degree of carotid stenosis and low-to-moderate degree of cognitive impairment on the right side (p < 0.05) and left side (p < 0.05). A moderately weak negative statistically significant correlation between the severity of cognitive impairment and the degree of stenosis in the asymptomatic group was reported. A high degree of carotid stenosis (≥70%) on the right increased the chance of a moderate degree of cognitive impairment by 6 times compared to the low degree of carotid stenosis in the asymptomatic group. The high degree of carotid stenosis (≥70%) on the left increased the chance of a severe degree of cognitive impairment by 20 times compared to the low degree of stenosis in the asymptomatic group.

CONCLUSIONS: ACS increases the risk of cognitive impairment.


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Joveva E, Karakolevska-Ilova M, Jovev M, Petrovski S, Serafimov A, Dimitrovska-Ivanova M. Association Between Inflammatory Markers and Cognitive Impairment in Patients with Asymptomatic Carotid Stenosis. Open Access Maced J Med Sci [Internet]. 2024 Mar. 20 [cited 2024 May 26];12:1-8. Available from:





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