DOI: 10.1161/01.atv.17.6.1121. Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly

Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly

10.1161/01.atv.17.6.1121

Crossref journal-article

Ovid Technologies (Wolters Kluwer Health)

Arteriosclerosis, Thrombosis, and Vascular Biology (276)

Abstract

Abstract Markers of inflammation, such as C-reactive protein (CRP), are related to risk of cardiovascular disease (CVD) events in those with angina, but little is known about individuals without prevalent clinical CVD. We performed a prospective, nested case-control study in the Cardiovascular Health Study (CHS; 5201 healthy elderly men and women). Case subjects (n=146 men and women with incident CVD events including angina, myocardial infarction, and death) and control subjects (n=146) were matched on the basis of sex and the presence or absence of significant subclinical CVD at baseline (average follow-up, 2.4 years). In women but not men, the mean CRP level was higher for case subjects than for control subjects ( P ≤.05). In general, CRP was higher in those with subclinical disease. Most of the association of CRP with female case subjects versus control subjects was in the subgroup with subclinical disease: 3.33 versus 1.90 mg/L, P <.05, adjusted for age and time of follow-up. Case-control differences were greatest when the time between baseline and the CVD event was shortest. The strongest associations were with myocardial infarction, and there was an overall odds ratio for incident myocardial infarction for men and women with subclinical disease (upper quartile versus lower three quartiles) of 2.67 (confidence interval [CI]=1.04 to 6.81), with the relationship being stronger in women (4.50 [CI=0.97 to 20.8]) than in men (1.75 [CI=0.51 to 5.98]). We performed a similar study in the Rural Health Promotion Project, in which mean values of CRP were higher for female case subjects than for female control subjects, but no differences were apparent for men. Comparing the upper quintile with the lower four, the odds ratio for CVD case subjects was 2.7 (CI=1.10 to 6.60). In conclusion, CRP was associated with incident events in the elderly, especially in those with subclinical disease at baseline.

Bibliography

Tracy, R. P., Lemaitre, R. N., Psaty, B. M., Ives, D. G., Evans, R. W., Cushman, M., Meilahn, E. N., & Kuller, L. H. (1997). Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly. Arteriosclerosis, Thrombosis, and Vascular Biology, 17(6), 1121â1127.

Authors 8

Russell P. Tracy (first)
Rozenn N. Lemaitre (additional)
Bruce M. Psaty (additional)
Diane G. Ives (additional)
Rhobert W. Evans (additional)
Mary Cushman (additional)
Elaine N. Meilahn (additional)
Lewis H. Kuller (additional)

References 37 Referenced 538

10.3109/00313029109060809
10.1056/NEJM199503093321003
Liuzzo G Biasucci L Gallimore J Grillo R Rebuzzi A Pepys M Maseri A. The prognostic value of C-reactive protein and serum amyloid A protein in severe unstable angina. N Engl J Med . 1994; 331:417-424. (10.1056/NEJM199408183310701)
Kuller L Tracy R Shaten J Meilahn E for the MRFIT Research Group. Relationship of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Am J Epidemiol . In press.
10.1016/S0065-2776(08)60379-X
Fuster V Stein B Ambrose JA Badimon L Badimon JJ Chesebro JH. Atherosclerotic plaque rupture and thrombosis: evolving concepts. Circulation . 1990;82(part 3):II-47-II-59.
10.1056/NEJM199201233260406
10.1182/blood.V82.2.513.513
10.1016/0009-8981(85)90133-0
Tracy R Bovill EG Macy EM Cornell ES Kuller LH Psaty BM Wahl PW. Presented at the American Heart Association Scientific Conference on Atherosclerosis Thrombosis and Cell Proliferation; February 23-26 1994; Orlando Fla.
10.1093/oxfordjournals.aje.a116963
10.1161/circ.92.4.720
10.1016/1047-2797(91)90005-W
10.1093/oxfordjournals.aje.a116678
10.1016/1047-2797(94)00093-9
10.1016/1047-2797(94)00092-8
10.1016/S0749-3797(18)30500-2
10.1016/0091-7435(92)90066-Q
10.1093/clinchem/43.1.52
10.1093/clinchem/41.2.264
Kahn H Sempos C. Statistical Methods in Epidemiology . New York NY: Oxford University Press; 1989.
10.1093/oxfordjournals.aje.a116030
10.1016/S0140-6736(86)90111-X
Haverkate F. Low-grade acute-phase reactions in arteriosclerosis and the consequences for haemostasis. Fibrinolysis . 1992;6(suppl 3): 17-18. (10.1016/0268-9499(92)90006-4)
10.1016/S0140-6736(94)93084-8
10.1093/ije/23.6.1315
10.1146/annurev.me.43.020192.001533
10.1161/circ.87.4.8484830
10.7326/0003-4819-116-4-273
10.1016/S0140-6736(88)90741-6
Kuo C Grayston J Campbell L Goo Y Wissler R Benditt E. Chlamydia pneumoniae (TWAR) in coronary arteries of young adults (15-34 years old). Proc Natl Acad Sci U S A . 1995;92: 6911-6914. (10.1073/pnas.92.15.6911)
Tracy R Bovill E. Hemostasis and risk of ischemic disease: epidemiologic evidence with emphasis on the elderly. In: Califf R Mark D Wagner G eds. Acute Coronary Care in the Thrombolytic Era . St Louis Mo: Mosby-Year Book Inc; 1995:27-43.
{'key': 'e_1_3_2_33_2', 'first-page': '1307', 'volume': '116', 'year': '1992', 'journal-title': 'Arch Pathol Lab Med'} / Arch Pathol Lab Med (1992)
10.1161/atvb.15.9.1269
10.1056/NEJM199408183310709
10.1056/NEJM199201303260506
10.1016/0735-1097(94)90772-2

Dates

Type	When
Created	14 years, 2 months ago (June 17, 2011, 3:44 p.m.)
Deposited	3 years, 5 months ago (March 17, 2022, 1:49 p.m.)
Indexed	3 days, 4 hours ago (Sept. 3, 2025, 7:15 a.m.)
Issued	28 years, 3 months ago (June 1, 1997)
Published	28 years, 3 months ago (June 1, 1997)
Published Print	28 years, 3 months ago (June 1, 1997)

Funders 0

None

BibTeX

@article{Tracy_1997, title={Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly: Results From the Cardiovascular Health Study and the Rural Health Promotion Project}, volume={17}, ISSN={1524-4636}, url={http://dx.doi.org/10.1161/01.atv.17.6.1121}, DOI={10.1161/01.atv.17.6.1121}, number={6}, journal={Arteriosclerosis, Thrombosis, and Vascular Biology}, publisher={Ovid Technologies (Wolters Kluwer Health)}, author={Tracy, Russell P. and Lemaitre, Rozenn N. and Psaty, Bruce M. and Ives, Diane G. and Evans, Rhobert W. and Cushman, Mary and Meilahn, Elaine N. and Kuller, Lewis H.}, year={1997}, month=jun, pages={1121–1127} }

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