Marikka Kuoppamäki1, Marika Salminen2, Tero Vahlberg3, Kerttu Irjala4, Sirkka-Liisa Kivelä5, Ismo Räihä6. 1. Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland; Naantali Health Centre, Naantali, Finland. 2. Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland; Härkätie Health Centre, Lieto, Finland; Unit of Family Medicine, Turku University Hospital, Turku, Finland. Electronic address: majosa@utu.fi. 3. Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland. 4. Mehiläinen Oy, Finland. 5. Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, Finland. 6. Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland; Department of Internal Medicine, Turku City Hospital, Turku, Finland.
Abstract
OBJECTIVE: The clinical utility of application of hsCRP categorization and the association of hsCRP with vascular disease (VD) events are less studied among the aged. This study investigated whether an elevated hsCRP has an additive effect on conventional vascular risk factors in predicting cardiovascular morbidity and all-cause mortality among the aged. METHODS AND RESULTS: a prospective population-based study with a 9-year follow-up among persons aged ≥64 and without VD and C-reactive protein (CRP)<10mg/L at baseline (n=771). Adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for VDs and all-cause mortality predicted by hsCRP level were estimated. During the follow-up, there were 151 major VD events, and 217 subjects died. After the adjustment for age and gender or risk factors related to VD events or a metabolic syndrome (MetS), hsCRP was not related to incident VD events (HR 1.14, 95% CI 0.96-1.35, p=.127 or 1.11, 0.94-1.32, p=.212, respectively). hsCRP predicted all-cause mortality after the adjustment for age and gender (1.18, 1.03-1.36, p=.020) and multiple factors (1.16, 1.00-1.33, p=.046) but not beyond conventional risk factors. High risk participants (hsCRP 3.0-9.9mg/L) had higher age and gender adjusted (1.50, 1.07-2.10, p=.018) and tended to have higher risk factor adjusted all-cause mortality (1.41, 1.00-2.00, p=.052) compared with low risk participants (hsCRP<1mg/L). CONCLUSIONS: hsCRP may not be useful in prediction of cardiovascular events.
OBJECTIVE: The clinical utility of application of hsCRP categorization and the association of hsCRP with vascular disease (VD) events are less studied among the aged. This study investigated whether an elevated hsCRP has an additive effect on conventional vascular risk factors in predicting cardiovascular morbidity and all-cause mortality among the aged. METHODS AND RESULTS: a prospective population-based study with a 9-year follow-up among persons aged ≥64 and without VD and C-reactive protein (CRP)<10mg/L at baseline (n=771). Adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for VDs and all-cause mortality predicted by hsCRP level were estimated. During the follow-up, there were 151 major VD events, and 217 subjects died. After the adjustment for age and gender or risk factors related to VD events or a metabolic syndrome (MetS), hsCRP was not related to incident VD events (HR 1.14, 95% CI 0.96-1.35, p=.127 or 1.11, 0.94-1.32, p=.212, respectively). hsCRP predicted all-cause mortality after the adjustment for age and gender (1.18, 1.03-1.36, p=.020) and multiple factors (1.16, 1.00-1.33, p=.046) but not beyond conventional risk factors. High risk participants (hsCRP 3.0-9.9mg/L) had higher age and gender adjusted (1.50, 1.07-2.10, p=.018) and tended to have higher risk factor adjusted all-cause mortality (1.41, 1.00-2.00, p=.052) compared with low risk participants (hsCRP<1mg/L). CONCLUSIONS: hsCRP may not be useful in prediction of cardiovascular events.