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C-reactive protein and the 10-year incidence of coronary heart disease in older men and women: the cardiovascular health study.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | C-reactive protein and the 10-year incidence of coronary heart disease in older men and women: the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Cushman, M, Arnold, AM, Psaty, BM, Manolio, TA, Kuller, LH, Burke, GL, Polak, JF, Tracy, RP |
| Journal | Circulation |
| Volume | 112 |
| Issue | 1 |
| Pagination | 25-31 |
| Date Published | 2005 Jul 05 |
| ISSN | 1524-4539 |
| Keywords | Age Factors, Aged, Aged, 80 and over, Biomarkers, C-Reactive Protein, Coronary Disease, Female, Humans, Incidence, Inflammation, Male, Myocardial Infarction, Predictive Value of Tests, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>High C-reactive protein (CRP) is associated with increased coronary heart disease risk. Few long-term data in the elderly are available.</p><p><b>METHODS AND RESULTS: </b>Baseline CRP was measured in 3971 men and women > or =65 years of age without prior vascular diseases; 26% had elevated concentrations (>3 mg/L). With 10 years of follow-up, 547 participants developed coronary heart disease (CHD; defined as myocardial infarction or coronary death). With elevated CRP, the 10-year cumulative CHD incidences were 33% in men and 17% in women. The age-, ethnicity-, and sex-adjusted relative risk of CHD for CRP >3 mg/L compared with <1 mg/L was 1.82 (95% CI, 1.46 to 2.28). Adjusting for conventional risk factors reduced the relative risk to 1.45 (95% CI, 1.14 to 1.86). The population-attributable risk of CHD for elevated CRP was 11%. Risk relationships did not differ in subgroups defined by baseline risk factors. We assessed whether CRP improved prediction by the Framingham Risk Score. Among men with a 10-year Framingham-predicted risk of 10% to 20%, the observed CHD incidence was 32% for elevated CRP. Among women, CRP discriminated best among those with a 10-year predicted risk >20%; the incidences were 31% and 10% for elevated and normal CRP levels, respectively.</p><p><b>CONCLUSIONS: </b>In older men and women, elevated CRP was associated with increased 10-year risk of CHD, regardless of the presence or absence of cardiac risk factors. A single CRP measurement provided information beyond conventional risk assessment, especially in intermediate-Framingham-risk men and high-Framingham-risk women.</p> |
| DOI | 10.1161/CIRCULATIONAHA.104.504159 |
| Alternate Journal | Circulation |
| PubMed ID | 15983251 |
| Grant List | HL-03618 / HL / NHLBI NIH HHS / United States HL-46696 / HL / NHLBI NIH HHS / United States HL-8329 / HL / NHLBI NIH HHS / United States N01-HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States |