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Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:09 America/Los_Angeles — eenright
| Title | Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2007 |
| Authors | Novaro, GM, Katz, R, Aviles, RJ, Gottdiener, JS, Cushman, M, Psaty, BM, Otto, CM, Griffin, BP |
| Journal | J Am Coll Cardiol |
| Volume | 50 |
| Issue | 20 |
| Pagination | 1992-8 |
| Date Published | 2007 Nov 13 |
| ISSN | 1558-3597 |
| Keywords | Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, C-Reactive Protein, Calcinosis, Cardiovascular Diseases, Cohort Studies, Disease Progression, Female, Follow-Up Studies, Heart Valve Diseases, Humans, Male, Risk Factors |
| Abstract | <p><b>OBJECTIVES: </b>The purpose of this study was to examine the relationship between C-reactive protein (CRP) and calcific aortic valve disease in a large, randomly selected, population-based cohort.</p><p><b>BACKGROUND: </b>The pathobiology of calcific aortic stenosis involves an active inflammatory, atheromatous, osteogenic process. Elevations in CRP, a measure of systemic inflammation, have been associated with aortic stenosis.</p><p><b>METHODS: </b>Two-dimensional and Doppler echocardiography and CRP measurement were performed at baseline in 5,621 participants in the Cardiovascular Health Study. Multivariable analysis was used to identify CRP as a predictor of baseline and incident aortic stenosis.</p><p><b>RESULTS: </b>At a mean echocardiographic follow-up of 5 years, 9% of subjects with aortic sclerosis progressed to some degree of aortic stenosis. Increasing age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.16; p < 0.001) and male gender (OR 3.05, 95% CI 1.76 to 5.27; p < 0.001) were related to risk of incident aortic stenosis, whereas increasing height (OR 0.96, 95% CI 0.94 to 0.99; p = 0.013) and African-American ethnicity conveyed a lower risk (OR 0.49, 95% CI 0.25 to 0.95; p = 0.035). C-reactive protein, treated as a continuous variable, was not associated with baseline aortic stenosis, progression to aortic sclerosis (adjusted OR 0.93, 95% CI 0.85 to 1.02; p = 0.107), or progression to aortic stenosis (adjusted OR 0.85, 95% CI 0.70 to 1.03; p = 0.092).</p><p><b>CONCLUSIONS: </b>In this large population-based cohort, approximately 9% of subjects with aortic sclerosis progressed to aortic stenosis over a 5-year follow-up period. There was no association between CRP levels and the presence of calcific aortic-valve disease or incident aortic stenosis. C-reactive protein appears to be a poor predictor of subclinical calcific aortic-valve disease.</p> |
| DOI | 10.1016/j.jacc.2007.07.064 |
| Alternate Journal | J Am Coll Cardiol |
| PubMed ID | 17996566 |