Plasma Concentration of C-Reactive Protein and Risk of Developing Peripheral Vascular Disease
- 10 February 1998
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 97 (5), 425-428
- https://doi.org/10.1161/01.cir.97.5.425
Abstract
Background—Among apparently healthy men, elevated levels of C-reactive protein (CRP), a marker for systemic inflammation, predict risk of myocardial infarction and thromboembolic stroke. Whether increased levels of CRP are also associated with the development of symptomatic peripheral arterial disease (PAD) is unknown.Methods and Results—Using a prospective, nested, case-control design, we measured baseline levels of CRP in 144 apparently healthy men participating in the Physicians’ Health Study who subsequently developed symptomatic PAD (intermittent claudication or need for revascularization) and in an equal number of control subjects matched on the basis of age and smoking habit who remained free of vascular disease during a follow-up period of 60 months. Median CRP levels at baseline were significantly higher among those who subsequently developed PAD (1.34 versus 0.99 mg/L;P=.04). Furthermore, the risks of developing PAD increased significantly with each increasing quartile of baseline CRP concentration such that relative risks of PAD from lowest (referent) to highest quartile of CRP were 1.0, 1.3, 2.0, and 2.1 (Ptrend=.02). Compared with those with no clinical evidence of disease, the subgroup of case patients who required revascularization had the highest baseline CRP levels (median=1.75 mg/L;P=.04); relative risks from lowest to highest quartile of CRP for this end point were 1.0, 1.8, 3.8, and 4.1 (Ptrend=.02). Risk estimates were similar after additional control for body mass index, hypercholesterolemia, hypertension, diabetes, and a family history of premature atherosclerosis.Conclusions—These prospective data indicate that among apparently healthy men, baseline levels of CRP predict future risk of developing symptomatic PAD and thus provide further support for the hypothesis that chronic inflammation is important in the pathogenesis of atherothrombosis.Keywords
This publication has 12 references indexed in Scilit:
- Chronic infections and coronary heart disease: is there a link?The Lancet, 1997
- Prevention of In vitro neutrophil adhesion to endothelial cells through shedding of L-selectin by C-reactive protein and peptides derived from C-reactive protein.JCI Insight, 1997
- Inflammation, Aspirin, and the Risk of Cardiovascular Disease in Apparently Healthy MenNew England Journal of Medicine, 1997
- Relation of C-Reactive Protein and Coronary Heart Disease in the MRFIT Nested Case-Control StudyAmerican Journal of Epidemiology, 1996
- Hemostatic Factors and the Risk of Myocardial Infarction or Sudden Death in Patients with Angina PectorisNew England Journal of Medicine, 1995
- The Prognostic Value of C-Reactive Protein and Serum Amyloid A Protein in Severe Unstable AnginaNew England Journal of Medicine, 1994
- C‐reactive protein levels as a direct indicator of interleukin‐6 levels in humans in vivoArthritis & Rheumatism, 1992
- Low-dose aspirin and subsequent peripheral arterial surgery in the Physicians' Health StudyThe Lancet, 1992
- Final Report on the Aspirin Component of the Ongoing Physicians' Health StudyNew England Journal of Medicine, 1989
- Binding of C‐reactive protein to human neutrophilsFEBS Letters, 1987