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C-reactive protein and myocardial infarction
Pamela Sakkinen1, Robert D Abbott, J David Curb
1Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA.
Insights
C-reactive protein (CRP) predicts myocardial infarction (MI) risk in men. Elevated CRP levels were associated with increased MI odds, particularly in younger, healthier individuals, suggesting inflammation
Area of Science:
- Cardiovascular Disease Research
- Inflammation Biomarkers
Background:
- C-reactive protein (CRP) is a known predictor of cardiovascular disease.
- The differential impact of CRP on cardiovascular risk across various strata and follow-up durations requires further investigation.
Purpose of the Study:
- To evaluate the association between C-reactive protein (CRP) levels and the incidence of myocardial infarction (MI) over a 20-year follow-up period.
- To examine how this association varies based on cardiovascular risk factors and follow-up duration.
Main Methods:
- A case-control study design was employed within the Honolulu Heart Program.
- 369 myocardial infarction (MI) cases were compared with 1,348 control subjects, aged 48-70 years and initially free of disease.
- Statistical analyses were adjusted for cardiovascular risk factors.
Main Results:
- Increased C-reactive protein (CRP) levels were significantly associated with higher odds of myocardial infarction (MI) as early as 5 years post-measurement (P = 0.009).
- This association persisted over time, though effects diminished after 15 years.
- Elevated CRP showed a more pronounced adverse effect in younger men (≤55 years), non-smokers, and those without hypertension or diabetes.
Conclusions:
- In clinically healthy middle-aged men, elevated C-reactive protein (CRP) is linked to an increased risk of myocardial infarction (MI).
- Inflammation, as indicated by CRP, may play a crucial role in the early stages of atherosclerosis, potentially preceding other risk factors.
- The predictive value of CRP for MI risk is influenced by individual risk factor profiles and follow-up duration.
Abstract:
C-reactive protein (CRP) has been shown to predict cardiovascular disease. Whether predictions differ across risk factor strata and for short and long-term follow-up has not been clearly examined. The purpose of this report is to assess the relation between CRP and the development of myocardial infarction (MI) over a 20-year period in men in the Honolulu Heart Program. Subjects were aged 48 to 70 years and free of prevalent disease at the time when CRP levels were measured and follow-up began. Using a case-control design, 369 cases of MI were compared with 1,348 control subjects. After risk factor adjustment, the odds of an MI rose with increasing levels of CRP as early as 5 years into follow-up (P = 0.009). Associations appeared to persist beyond this time, but after 15 years, effects became modest. Adverse effects of an elevated CRP level were observed in middle-aged men (< or =55 years), in men without hypertension or diabetes, and in those who were nonsmokers (P < 0.05). Although positive effects were also observed in those who were hypertensive and smoking at the time of CRP measurement, findings suggest that in clinically healthy men, atherosclerosis could have origins more closely linked with inflammation than with other processes.