Antonio Bernabe-Ortiz1, Rodrigo M Carrillo-Larco2, Robert H Gilman3, Liam Smeeth4, William Checkley5, J Jaime Miranda6. 1. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru. Electronic address: Antonio.Bernabe@upch.pe. 2. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. 3. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, US. 4. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 5. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, US. 6. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
Abstract
PURPOSE: To assess the association between all-cause mortality and hs-CRP, based mainly on the cumulative burden approach. METHODS: Cohort study with adults ≥35 years from general population, using hs-CRP at two timepoints: at baseline and 30 months later to establish different exposures: change over time, cumulative, and weighted cumulative hs-CRP. The outcome was all-cause mortality assessed 7 years later. Cox models were generated to quantify the association. RESULTS: Data from 3,119 participants (mean age 55.6 years, and 51.2% females), were analyzed. During follow-up, 164 (5.6%) deaths occurred over 20,314.5 person-years, indicating an overall mortality rate of 8.1 per 1,000 person-years. In multivariable model, hs-CRP at baseline was associated with high risk of mortality (HR = 1.77; 95%CI: 1.28-2.46). Similarly, hs-CRP change over time (HR = 2.50; 95%CI: 1.46-4.29), as well as cumulative and weighted cumulative hs-CRP (HR = 2.05; 95%CI: 1.31-3.20) were associated with greater risk of all-cause mortality. The weighted cumulative hs-CRP had the best goodness-of-fit for mortality prediction. CONCLUSIONS: In this cohort across diverse geographical low-resource settings, high levels of hs-CRP were strongly associated with all-cause mortality. Two measurements of hs-CRP are better than one to predict mortality, and the weighted cumulative approach had the best prognostic fit.
PURPOSE: To assess the association between all-cause mortality and hs-CRP, based mainly on the cumulative burden approach. METHODS: Cohort study with adults ≥35 years from general population, using hs-CRP at two timepoints: at baseline and 30 months later to establish different exposures: change over time, cumulative, and weighted cumulative hs-CRP. The outcome was all-cause mortality assessed 7 years later. Cox models were generated to quantify the association. RESULTS: Data from 3,119 participants (mean age 55.6 years, and 51.2% females), were analyzed. During follow-up, 164 (5.6%) deaths occurred over 20,314.5 person-years, indicating an overall mortality rate of 8.1 per 1,000 person-years. In multivariable model, hs-CRP at baseline was associated with high risk of mortality (HR = 1.77; 95%CI: 1.28-2.46). Similarly, hs-CRP change over time (HR = 2.50; 95%CI: 1.46-4.29), as well as cumulative and weighted cumulative hs-CRP (HR = 2.05; 95%CI: 1.31-3.20) were associated with greater risk of all-cause mortality. The weighted cumulative hs-CRP had the best goodness-of-fit for mortality prediction. CONCLUSIONS: In this cohort across diverse geographical low-resource settings, high levels of hs-CRP were strongly associated with all-cause mortality. Two measurements of hs-CRP are better than one to predict mortality, and the weighted cumulative approach had the best prognostic fit.
Authors: Claudia Marsik; Lili Kazemi-Shirazi; Thomas Schickbauer; Stefan Winkler; Christian Joukhadar; Oswald F Wagner; Georg Endler Journal: Clin Chem Date: 2007-12-21 Impact factor: 8.327
Authors: Massimiliano Ruscica; Peter E Penson; Nicola Ferri; Cesare R Sirtori; Matteo Pirro; G B John Mancini; Naveed Sattar; Peter P Toth; Amirhossein Sahebkar; Carl J Lavie; Nathan D Wong; Maciej Banach Journal: Prog Cardiovasc Dis Date: 2021-06-27 Impact factor: 8.194
Authors: J Jaime Miranda; Antonio Bernabe-Ortiz; Liam Smeeth; Robert H Gilman; William Checkley Journal: BMJ Open Date: 2012-01-11 Impact factor: 2.692