Related Experiment Videos
C-reactive protein and microalbuminuria differ in their associations with various domains of vascular disease
Erik M Stuveling1, Hans L Hillege, Stephan J L Bakker
1Department of Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands.
Insights
C-reactive protein (CRP) and microalbuminuria (MA) are risk markers for cardiovascular disease (CVD). CRP associates with heart, kidney, and extremity vascular disease, while MA primarily links to coronary heart disease.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Vascular Biology
Background:
- C-reactive protein (CRP) and microalbuminuria (MA) are established risk markers for cardiovascular disease (CVD).
- The differential association of CRP and MA with various vascular beds (heart, kidneys, extremities) remains incompletely understood.
- Understanding these differences is crucial for refining risk stratification and targeted interventions.
Purpose of the Study:
- To investigate whether CRP and MA serve as similar or distinct markers of vascular disease across different vascular territories.
- To compare the independent associations of CRP and MA with coronary heart disease, renal insufficiency, and peripheral artery disease.
Main Methods:
- Analysis of baseline CRP and urinary albumin levels in 6669 non-diabetic participants from the Prevention of Renal and Vascular ENdstage Disease (PREVEND) study.
- Definition of three vascular disease domains: coronary heart disease, renal insufficiency, and peripheral artery disease.
- Multivariate analyses to assess independent associations of CRP and MA with each vascular domain, considering age and other confounders.
Main Results:
- Elevated CRP and MA prevalence were higher in individuals with vascular disease compared to those without.
- CRP prevalence was similar across coronary, renal, and peripheral artery disease groups.
- MA prevalence was highest in subjects with coronary heart disease, and CRP was independently associated with all three vascular domains, whereas MA was only associated with coronary heart disease.
Conclusions:
- CRP and MA are significant risk markers for vascular disease, but they exhibit distinct associations with different vascular beds.
- CRP demonstrates a broad association with cardiovascular, renal, and peripheral vascular disease.
- MA is predominantly associated with coronary heart disease, highlighting differential risk profiling for specific vascular territories.
Abstract:
C-reactive protein (CRP) and microalbuminuria (MA) have been identified as risk markers for cardiovascular disease (CVD). We questioned whether CRP and MA are similar markers of vascular disease in different regions of the vascular tree like the heart, kidneys and extremities or if they differ in their relationships with these vascular beds. Baseline levels of CRP and urinary albumin were measured in 6669 non-diabetic participants in the Prevention of Renal and Vascular ENdstage Disease (PREVEND) study, a Dutch cohort derived from the general population. We defined three domains of vascular disease; coronary heart disease (myocardial infarction or infarct pattern on the ECG), renal insufficiency (creatinine clearance <60 ml min(-1)) and peripheral artery disease (ankle brachial index <0.9 or lower limb revascularisation). The prevalence of an elevated CRP (27.7 vs. 17.9%) and MA (17.5 vs. 10.4%) were increased in subjects with vascular disease as compared with subjects without CVD. The prevalence of an elevated CRP was equal in subjects with either coronary heart disease, renal insufficiency or peripheral artery disease (28.4 vs. 29.5 vs. 26.0%, NS), whereas MA was most prevalent in subjects with coronary heart disease (22.5 vs. 12.8 vs. 14.9%, P<0.05). Using multivariate analyses, CRP was independently associated with all three domains of vascular disease, whereas MA was independently associated with coronary heart disease only. In addition, we found synergistic contributions of an elevated CRP and older age to the risk of vascular disease in all three domains. Thus, CRP and MA are risk markers for vascular disease, each showing a different risk profiling for different vascular beds.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:28Diabetic Nephropathy
01:26Nephrotic Syndrome II : Assessment and Medical Management
01:20Vascular Resistance
The primary determinants of vascular resistance are vessel diameter, blood viscosity, and vessel length. Among these, vessel diameter plays the most significant role due to the fourth power relationship described by...