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C-reactive protein and incident coronary heart disease in the Atherosclerosis Risk In Communities (ARIC) study

Aaron R Folsom1, Nena Aleksic, Diane Catellier

  • 1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minn 55454-1015, USA. folsom@epi.umn.edu

American Heart Journal
|August 15, 2002
PubMed

Insights

Inflammation, indicated by C-reactive protein (CRP), is linked to coronary heart disease (CHD) risk in middle-aged adults. Other inflammatory markers largely explained this association, suggesting a broader inflammatory role in CHD.

Area of Science:

  • Cardiovascular Medicine
  • Inflammation Research
  • Epidemiology

Background:

  • Inflammation is increasingly recognized in the development of coronary heart disease (CHD).
  • C-reactive protein (CRP) is a plasma marker of inflammation and a potential indicator of CHD risk.
  • Limited prospective studies have investigated CRP's role in general populations.

Purpose of the Study:

  • To prospectively examine the association between C-reactive protein (CRP) and incident coronary heart disease (CHD).
  • To investigate the role of inflammation as a marker of CHD risk in middle-aged adults.

Main Methods:

  • A nested case-cohort approach was used within the Atherosclerosis Risk In Communities (ARIC) study.
  • CRP levels were measured in baseline blood samples from individuals who developed CHD and from a comparison group of non-cases.
  • Analyses were adjusted for demographic variables and traditional CHD risk factors.

Main Results:

  • A significant trend was observed between CRP levels and incident CHD risk (P for trend =.01).
  • Relative risks of CHD increased with higher CRP quintiles, indicating elevated risk.
  • The association between CRP and CHD incidence was attenuated when other inflammatory markers (fibrinogen, ICAM-1, WBC) were included in the analysis.

Conclusions:

  • C-reactive protein is a moderately strong marker of CHD risk in middle-aged adults.
  • Findings support the role of inflammation in the pathogenesis of CHD events.
  • The observed association of CRP with CHD was not entirely specific, as other inflammatory markers could account for a significant portion of the effect.
Abstract

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