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Association of very highly elevated C-reactive protein concentration with cardiovascular events and all-cause

Mark Hamer1, Yoichi Chida, Emmanuel Stamatakis

  • 1Department of Epidemiology and Public Health, University College London, London, UK. m.hamer@ucl.ac.uk

Clinical Chemistry
|November 4, 2009
PubMed

Insights

Very high high-sensitivity C-reactive protein (hsCRP) levels over 10 mg/L significantly predict cardiovascular disease (CVD) events and all-cause mortality. This elevated hsCRP offers meaningful prognostic information beyond conventional risk factors.

Area of Science:

  • Cardiology
  • Biomarkers
  • Public Health

Background:

  • The clinical significance of very high high-sensitivity C-reactive protein (hsCRP) concentrations (>10 mg/L) remains unclear.
  • This study investigates the association between elevated hsCRP and the risk of cardiovascular disease (CVD) and mortality.

Purpose of the Study:

  • To determine if very highly increased hsCRP levels predict incident CVD events and all-cause mortality.
  • To assess the added prognostic value of hsCRP to conventional CVD risk models.

Main Methods:

  • A cohort of 5248 participants without pre-existing CVD or infection was recruited from the Scottish Health Survey.
  • Baseline measurements included hsCRP, conventional risk factors, and demographic data.
  • Participants were followed for an average of 7 years for CVD events and all-cause mortality.

Main Results:

  • Very highly increased hsCRP (>10 mg/L) was independently associated with a 2.40-fold increased risk of CVD events and a 3.64-fold increased risk of all-cause death.
  • Adding hsCRP to the Framingham Risk Score reclassified 7.4% of participants into a higher CVD risk category.
  • Elevated hsCRP correlated with modifiable risk factors like smoking, low HDL cholesterol, and central obesity.

Conclusions:

  • hsCRP levels >10 mg/L are a stronger predictor of clinical events than the conventional threshold of 3 mg/L.
  • Very high hsCRP concentrations provide clinically relevant prognostic information for cardiovascular events and mortality.
Abstract

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