C-Reactive Protein, a Sensitive Marker of Inflammation, Predicts Future Risk of Coronary Heart Disease in Initially Healthy Middle-Aged Men
- 19 January 1999
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 99 (2), 237-242
- https://doi.org/10.1161/01.cir.99.2.237
Abstract
Background—Inflammatory reactions in coronary plaques play an important role in the pathogenesis of acute atherothrombotic events; inflammation elsewhere is also associated with both atherogenesis generally and its thrombotic complications. Recent studies indicate that systemic markers of inflammation can identify subjects at high risk of coronary events.Methods and Results—We used a sensitive immunoradiometric assay to examine the association of serum C-reactive protein (CRP) with the incidence of first major coronary heart disease (CHD) event in 936 men 45 to 64 years of age. The subjects, who were sampled at random from the general population, participated in the first MONICA Augsburg survey (1984 to 1985) and were followed for 8 years. There was a positive and statistically significant unadjusted relationship, which was linear on the log-hazards scale, between CRP values and the incidence of CHD events (n=53). The hazard rate ratio (HRR) of CHD events associated with a 1-SD increase in log-CRP level was 1.67 (95% CI, 1.29 to 2.17). After adjustment for age, the HRR was 1.60 (95% CI, 1.23 to 2.08). Adjusting further for smoking behavior, the only variable selected from a variety of potential confounders by a forward stepping process with a 5% change in the relative risk of CRP as the selection criterion, yielded an HRR of 1.50 (95% CI, 1.14 to 1.97).Conclusions—These results confirm the prognostic relevance of CRP, a sensitive systemic marker of inflammation, to the risk of CHD in a large, randomly selected cohort of initially healthy middle-aged men. They suggest that low-grade inflammation is involved in pathogenesis of atherosclerosis, especially its thrombo-occlusive complications.This publication has 28 references indexed in Scilit:
- Immunohistochemical localization of C‐reactive protein‐binding sites in human atherosclerotic aortic lesions by a modified streptavidin‐biotin‐staining methodPathology International, 1995
- The mortality of rheumatoid arthritisArthritis & Rheumatism, 1994
- Extrahepatic transcription of human C-reactive protein.The Journal of Experimental Medicine, 1991
- Increased neutrophil elastase release in unstable angina pectoris and acute myocardial infarctionJournal of the American College of Cardiology, 1990
- Elevation of C-reactive protein in “active” coronary artery diseaseThe American Journal of Cardiology, 1990
- The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85Acta Medica Scandinavica, 1988
- The world health organization monica project (monitoring trends and determinants in cardiovascular disease): A major international collaborationJournal of Clinical Epidemiology, 1988
- Fibrin and Fibrinogen-Related Antigens in Patients with Stable and Unstable Coronary Artery DiseaseThe New England Journal of Medicine, 1987
- Immunohistochemical studies of c‐reactive protein and apolipoprotein b in inflammatory and arterial lesionsThe Journal of Pathology, 1985
- COMPLEMENT ACTIVATION BY C‐REACTIVE PROTEIN COMPLEXES*Annals of the New York Academy of Sciences, 1982