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Published on: February 4, 2021
Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: the
Gian M Novaro1, Ronit Katz, Ronnier J Aviles
1Department of Cardiology, Cleveland Clinic Florida, Weston, Florida 33331, USA. novarog@ccf.org
Insights
C-reactive protein (CRP) levels were not associated with the development or progression of calcific aortic valve disease in a large population study. This finding suggests CRP is a poor predictor for subclinical calcific aortic valve disease.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Epidemiology
Background:
- Calcific aortic stenosis involves inflammatory and osteogenic processes.
- Elevated C-reactive protein (CRP), a marker of systemic inflammation, has been linked to aortic stenosis.
Purpose of the Study:
- To investigate the association between C-reactive protein (CRP) and calcific aortic valve disease.
- To determine if CRP predicts the presence or progression of aortic stenosis in a population-based cohort.
Main Methods:
- Utilized data from 5,621 participants in the Cardiovascular Health Study.
- Performed two-dimensional and Doppler echocardiography and CRP measurements at baseline.
- Employed multivariable analysis to assess CRP as a predictor of baseline and incident aortic stenosis.
Main Results:
- Over a 5-year follow-up, 9% of subjects with aortic sclerosis progressed to aortic stenosis.
- Increasing age and male gender were risk factors for incident aortic stenosis.
- C-reactive protein (CRP) was not associated with baseline aortic stenosis, progression to aortic sclerosis, or progression to aortic stenosis.
Conclusions:
- In a large population-based cohort, CRP levels did not correlate with the presence or progression of calcific aortic valve disease.
- C-reactive protein is not a reliable predictor of subclinical calcific aortic valve disease.
- Approximately 9% of individuals with aortic sclerosis developed aortic stenosis over five years.
Objectives:
The purpose of this study was to examine the relationship between C-reactive protein (CRP) and calcific aortic valve disease in a large, randomly selected, population-based cohort.
Background:
The pathobiology of calcific aortic stenosis involves an active inflammatory, atheromatous, osteogenic process. Elevations in CRP, a measure of systemic inflammation, have been associated with aortic stenosis.
Methods:
Two-dimensional and Doppler echocardiography and CRP measurement were performed at baseline in 5,621 participants in the Cardiovascular Health Study. Multivariable analysis was used to identify CRP as a predictor of baseline and incident aortic stenosis.
Results:
At a mean echocardiographic follow-up of 5 years, 9% of subjects with aortic sclerosis progressed to some degree of aortic stenosis. Increasing age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.16; p < 0.001) and male gender (OR 3.05, 95% CI 1.76 to 5.27; p < 0.001) were related to risk of incident aortic stenosis, whereas increasing height (OR 0.96, 95% CI 0.94 to 0.99; p = 0.013) and African-American ethnicity conveyed a lower risk (OR 0.49, 95% CI 0.25 to 0.95; p = 0.035). C-reactive protein, treated as a continuous variable, was not associated with baseline aortic stenosis, progression to aortic sclerosis (adjusted OR 0.93, 95% CI 0.85 to 1.02; p = 0.107), or progression to aortic stenosis (adjusted OR 0.85, 95% CI 0.70 to 1.03; p = 0.092).
Conclusions:
In this large population-based cohort, approximately 9% of subjects with aortic sclerosis progressed to aortic stenosis over a 5-year follow-up period. There was no association between CRP levels and the presence of calcific aortic-valve disease or incident aortic stenosis. C-reactive protein appears to be a poor predictor of subclinical calcific aortic-valve disease.
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