C-Reactive Protein
Background: Both high-sensitivity C-reactive protein (hsCRP) and electron beam computed tomography (EBCT) coronary artery calcification (CAC) are valid markers of cardiovascular risk. It is unknown whether hsCRP is a marker of atherosclerotic burden or whether it reflects a process (eg, inflammatory fibrous cap degradation) leading to acute coronary events.
Methods: A nested case-control study was performed of 188 men enrolled in the Prospective Army Coronary Calcium study. The serum hsCRP levels (latex agglutination assay) were evaluated in subjects with CAC (CAC score >0, n = 94) and compared with age- and smoking status-matched control subjects (CAC score 0, n = 94).
Results: Levels of hsCRP in the highest quartile were related to the following coronary risk factors: smoking status, low-density lipoprotein cholesterol, body mass index, glycosylated hemoglobin, fibrinogen, and homocysteine. The mean hsCRP level was similar in cases (+CAC, 0.20 ± 0.22 mg/dL) and controls (-CAC, 0.19 ± 0.21 mg/dL; P = .81) and was unrelated to the log-transformed CAC score (r < 0.01, P = .91). Multivariable analysis controlling for standard risk factors, aspirin, and statin therapy found only that low-density lipoprotein cholesterol was related to CAC.
Conclusions: Despite associations with standard and emerging cardiovascular risk factors, hsCRP is unrelated to the presence and extent of calcified subclinical atherosclerosis. This implies that CAC (a disease marker) and hsCRP (a process marker) may be complementary for the prediction of cardiovascular risk.
Alternative markers of coronary heart disease (CHD) risk are needed because standard cardiovascular risk factors incompletely predict incident CHD events. Coronary artery calcification (CAC) is an anatomic disease marker that has been correlated with the presence and extent of coronary artery disease (CAD) and to the risk of future CHD events. High-sensitivity C-reactive protein (hsCRP), a serologic marker of inflammation, has also been associated with the risk of development of CHD. It is possible that hsCRP is predictive for CHD risk either through a correlation with CAD extent (a disease marker) or as an indicator of inflammation that leads to atherothrombotic events such as plaque rupture (a process marker). Defining the relationships between hsCRP and disease markers (such as CAC scores by electron beam computed tomography [EBCT] ) will enhance our understanding of whether inflammatory markers such as hsCRP would be complementary or redundant when combined with clinical risk prediction with EBCT. Thus the purpose of this analysis was to explore the relationships between hsCRP and CAC as measured by EBCT with use of data from participants of the Prospective Army Coronary Calcium study (PACC).
Background: Both high-sensitivity C-reactive protein (hsCRP) and electron beam computed tomography (EBCT) coronary artery calcification (CAC) are valid markers of cardiovascular risk. It is unknown whether hsCRP is a marker of atherosclerotic burden or whether it reflects a process (eg, inflammatory fibrous cap degradation) leading to acute coronary events.
Methods: A nested case-control study was performed of 188 men enrolled in the Prospective Army Coronary Calcium study. The serum hsCRP levels (latex agglutination assay) were evaluated in subjects with CAC (CAC score >0, n = 94) and compared with age- and smoking status-matched control subjects (CAC score 0, n = 94).
Results: Levels of hsCRP in the highest quartile were related to the following coronary risk factors: smoking status, low-density lipoprotein cholesterol, body mass index, glycosylated hemoglobin, fibrinogen, and homocysteine. The mean hsCRP level was similar in cases (+CAC, 0.20 ± 0.22 mg/dL) and controls (-CAC, 0.19 ± 0.21 mg/dL; P = .81) and was unrelated to the log-transformed CAC score (r < 0.01, P = .91). Multivariable analysis controlling for standard risk factors, aspirin, and statin therapy found only that low-density lipoprotein cholesterol was related to CAC.
Conclusions: Despite associations with standard and emerging cardiovascular risk factors, hsCRP is unrelated to the presence and extent of calcified subclinical atherosclerosis. This implies that CAC (a disease marker) and hsCRP (a process marker) may be complementary for the prediction of cardiovascular risk.
Alternative markers of coronary heart disease (CHD) risk are needed because standard cardiovascular risk factors incompletely predict incident CHD events. Coronary artery calcification (CAC) is an anatomic disease marker that has been correlated with the presence and extent of coronary artery disease (CAD) and to the risk of future CHD events. High-sensitivity C-reactive protein (hsCRP), a serologic marker of inflammation, has also been associated with the risk of development of CHD. It is possible that hsCRP is predictive for CHD risk either through a correlation with CAD extent (a disease marker) or as an indicator of inflammation that leads to atherothrombotic events such as plaque rupture (a process marker). Defining the relationships between hsCRP and disease markers (such as CAC scores by electron beam computed tomography [EBCT] ) will enhance our understanding of whether inflammatory markers such as hsCRP would be complementary or redundant when combined with clinical risk prediction with EBCT. Thus the purpose of this analysis was to explore the relationships between hsCRP and CAC as measured by EBCT with use of data from participants of the Prospective Army Coronary Calcium study (PACC).
Source...