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High-sensitivity C-reactive protein is quite low in Japanese men at high coronary risk
Kunihiro Matsushita1, Hiroshi Yatsuya, Koji Tamakoshi
1Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsusumai, Showa-ku, Nagoya 466-8550, Japan.
Insights
High-sensitivity C-reactive protein (CRP) correlates with coronary heart disease (CHD) risk in Japanese men. While CRP reflects risk, further studies are needed for Japanese-specific CHD risk evaluation cutoff points.
Area of Science:
- Cardiovascular Disease Epidemiology
- Biomarkers in Cardiology
- Preventive Cardiology
Background:
- High-sensitivity C-reactive protein (CRP) is linked to coronary heart disease (CHD) incidence globally.
- Limited data exists on the association between CRP and CHD risk specifically within the Japanese population.
Purpose of the Study:
- To investigate the association between CRP levels and estimated CHD risk using the Framingham Risk Score (FRS) in Japanese men.
- To evaluate the potential utility of CRP for coronary risk stratification in this demographic.
Main Methods:
- A cross-sectional study involving 2,523 middle-aged Japanese men with no prior history of CHD.
- CRP levels were measured and correlated with the FRS, calculated using established risk factors.
- Subjects were categorized into four groups based on their estimated CHD risk.
Main Results:
- CRP showed a significant association with the FRS across all components.
- A gradual increase in mean CRP levels was observed with increasing categories of CHD risk (p<0.001).
- Notably, a high proportion (63.8%) of individuals in the high-risk group had CRP levels below 1 mg/L.
Conclusions:
- Circulating CRP levels appear to reflect estimated CHD risk in Japanese men.
- CRP may serve as a valuable tool for coronary risk stratification in Japan.
- Further prospective studies are essential to establish Japanese-specific cutoff points for CRP-based CHD risk assessment.
Background:
Although numerous studies have demonstrated a positive association of high-sensitivity C-reactive protein (CRP) with the incidence of coronary heart disease (CHD), little information exists regarding this issue in Japanese.
Methods And Results:
The association between CRP and the Framingham Risk Score (FRS) was investigated in 2,523 middle-aged Japanese men without a medical history of CHD. CRP was significantly associated with this score obtained from all FRS factors. After dividing subjects into 4 categories of relative risk estimate for CHD, the geometric mean of CRP (mg/L) increased gradually with the CHD risk (below average: 0.39 [95% confidence interval, 0.37-0.41], average: 0.58 [0.50-0.67], moderately above average: 0.70 [0.57-0.86], high: 0.79 [0.58-1.09], trend p<0.001). However, it should be noted that the mean CRP concentration of the high-risk group was only 0.79 mg/L and a greater proportion (63.8%) of the high-risk subjects was in the low-risk range of CRP (<1 mg/L).
Conclusions:
Circulating CRP well reflect the estimated CHD risk, indicating that CRP may be useful for coronary risk stratification in Japanese also. However, the details of the CRP level in Japanese must be investigated further by prospective studies to determine the Japanese-specific cutoff points for CHD risk evaluation.
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