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C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease
John Danesh1, Jeremy G Wheeler, Gideon M Hirschfield
1Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
The New England Journal of Medicine
|April 9, 2004
Summary
C-reactive protein (CRP) is a moderate predictor of coronary heart disease (CHD). Its use in predicting CHD risk may require re-evaluation based on new study data and meta-analyses.
Area of Science:
- Cardiovascular Disease Research
- Biomarkers and Diagnostics
- Epidemiology
Background:
- C-reactive protein (CRP) is recognized as an inflammatory marker with potential in predicting coronary events.
- This study investigates the relevance of CRP and other inflammatory markers in predicting coronary heart disease (CHD).
Purpose of the Study:
- To evaluate the predictive value of C-reactive protein (CRP) for coronary heart disease (CHD).
- To compare the predictive performance of CRP against other inflammatory markers and established risk factors.
Main Methods:
- Analysis of baseline samples from up to 2459 CHD patients and 3969 controls in the Reykjavik prospective study.
- Assessment of within-person fluctuations in inflammatory markers using paired samples from 379 participants.
- Updated meta-analyses incorporating data from 7068 CHD patients.
Main Results:
- C-reactive protein (CRP) demonstrated a long-term stability comparable to blood pressure and total cholesterol.
- Adjusted odds ratio for CHD was 1.45 (95% CI, 1.25-1.68) for top vs. bottom CRP levels, confirmed by meta-analysis.
- CRP's predictive value was moderate compared to established risk factors like total cholesterol (OR 2.35) and smoking (OR 1.87).
Conclusions:
- C-reactive protein (CRP) is identified as a moderate predictor of coronary heart disease (CHD).
- Current recommendations for using CRP in CHD risk prediction may need revision.
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