INTRODUCTION: Measurement of C-reactive protein (CRP) levels has been proposed as a useful marker to improve the prediction of future coronary artery disease (CAD) risk, but this notion has been challenged recently. METHODS AND RESULTS: We performed a prospective case-control study among apparently healthy men and women. The odds ratio (OR) for future CAD incidence was 2.49 (95% CI=2.02-3.08, p for linearity <0.0001) unadjusted, and 1.66 (95% CI=1.31-2.12, p for linearity <0.0001), after adjustment for classical cardiovascular risk factors, for top versus bottom quartile of the CRP distribution. Notably, the risk factor adjusted predictive value was substantially stronger for fatal CAD (OR=2.92, 95% CI=1.83-4.67, p for linearity <0.0001) than for non-fatal CAD (OR=1.25, 95% CI=0.93-1.66, p for linearity=0.06). CRP levels were among the strongest predictors of CAD incidence and mortality. CRP levels remained a statistically significant predictor of future CAD, even after adjustment for the Framingham risk score. CONCLUSIONS: In this British cohort with risk factor levels representative of a contemporary Western population, CRP concentration was among the strongest predictors of CAD incidence and mortality. We suggest that current guidelines on CRP measurement in clinical practice should be based on contemporary and representative populations.
INTRODUCTION: Measurement of C-reactive protein (CRP) levels has been proposed as a useful marker to improve the prediction of future coronary artery disease (CAD) risk, but this notion has been challenged recently. METHODS AND RESULTS: We performed a prospective case-control study among apparently healthy men and women. The odds ratio (OR) for future CAD incidence was 2.49 (95% CI=2.02-3.08, p for linearity <0.0001) unadjusted, and 1.66 (95% CI=1.31-2.12, p for linearity <0.0001), after adjustment for classical cardiovascular risk factors, for top versus bottom quartile of the CRP distribution. Notably, the risk factor adjusted predictive value was substantially stronger for fatal CAD (OR=2.92, 95% CI=1.83-4.67, p for linearity <0.0001) than for non-fatal CAD (OR=1.25, 95% CI=0.93-1.66, p for linearity=0.06). CRP levels were among the strongest predictors of CAD incidence and mortality. CRP levels remained a statistically significant predictor of future CAD, even after adjustment for the Framingham risk score. CONCLUSIONS: In this British cohort with risk factor levels representative of a contemporary Western population, CRP concentration was among the strongest predictors of CAD incidence and mortality. We suggest that current guidelines on CRP measurement in clinical practice should be based on contemporary and representative populations.
Authors: Kasper Broedbaek; Volkert Siersma; Jon T Andersen; Morten Petersen; Shoaib Afzal; Brian Hjelvang; Allan Weimann; Richard D Semba; Luigi Ferrucci; Henrik E Poulsen Journal: Free Radic Res Date: 2011-01-28
Authors: Audrey J Gaskins; Machelle Wilchesky; Sunni L Mumford; Brian W Whitcomb; Richard W Browne; Jean Wactawski-Wende; Neil J Perkins; Enrique F Schisterman Journal: Am J Epidemiol Date: 2012-02-03 Impact factor: 4.897
Authors: Emily G Kurtz; Paul M Ridker; Lynda M Rose; Nancy R Cook; Brendan M Everett; Julie E Buring; Kathryn M Rexrode Journal: Menopause Date: 2011-01 Impact factor: 2.953
Authors: Kiran Musunuru; Brian G Kral; Roger S Blumenthal; Valentin Fuster; Catherine Y Campbell; Ty J Gluckman; Richard A Lange; Eric J Topol; James T Willerson; Milind Y Desai; Michael H Davidson; Samia Mora Journal: Nat Clin Pract Cardiovasc Med Date: 2008-08-19
Authors: Navaid Iqbal; Bailey Wentworth; Rajiv Choudhary; Alejandro De La Parra Landa; Benjamin Kipper; Arrash Fard; Alan S Maisel Journal: Cardiovasc Diagn Ther Date: 2012-06
Authors: Laura B Samuelsson; Martica H Hall; Shakir McLean; James H Porter; Lisa Berkman; Miguel Marino; Grace Sembajwe; Thomas W McDade; Orfeu M Buxton Journal: Biodemography Soc Biol Date: 2015