High-sensitivity C reactive protein and risk of cardiovascular disease in China-CVD study
Ying Dong1, Xin Wang1, Linfeng Zhang1
1Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Pecking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Insights
High sensitivity C-reactive protein (hs-CRP) is linked to a higher risk of cardiovascular disease (CVD) in middle-aged Chinese adults. Elevated hs-CRP levels, even if unchanged, indicate increased CVD risk, emphasizing its importance in prevention strategies.
Area of Science:
- Cardiology
- Biomarkers
- Public Health
Background:
- Cardiovascular disease (CVD) poses a significant health burden globally.
- Inflammatory markers, such as high-sensitivity C-reactive protein (hs-CRP), are increasingly recognized as potential contributors to CVD.
- Understanding the role of hs-CRP in diverse populations is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the association between hs-CRP levels and the incidence of CVD in a middle-aged Chinese population.
- To determine if changes in hs-CRP levels over time correlate with CVD risk.
- To evaluate the utility of hs-CRP as a risk predictor for CVD events.
Main Methods:
- A cohort of 8688 middle-aged Chinese adults, free from CVD at baseline (2009-2010), was followed until 2016-2017.
- hs-CRP levels were measured at baseline and follow-up using transmission turbidimetry.
- Cardiovascular events, including coronary heart disease and stroke, were recorded as primary outcomes.
Main Results:
- A progressive increase in CVD event rates was observed across increasing tertiles of baseline hs-CRP (p<0.001).
- Baseline hs-CRP showed a linear association with CVD risk (p=0.015) after adjusting for traditional risk factors.
- Adding hs-CRP to traditional risk models significantly improved CVD risk reclassification by 7.85% (p=0.003).
- No significant correlation was found between the change in hs-CRP levels and CVD incidence in a subgroup analysis (p=0.846).
Conclusions:
- Elevated hs-CRP levels are significantly associated with an increased risk of developing CVD in the middle-aged Chinese population.
- While changes in hs-CRP levels did not correlate with CVD, persistently high hs-CRP at follow-up was noted, even in those who developed CVD.
- Higher hs-CRP levels warrant greater attention for CVD prevention efforts in this demographic.
Background:
This study aimed to assess the association of high sensitivity C-reactive protein (hs-CRP) with cardiovascular disease (CVD) in middle-aged Chinese population.
Methods:
The baseline was collected 2009-2010, and follow-up was conducted in 2016-2017. Data of hs-CRP were from baseline examination and re-examination in 2016-2017 using transmission turbidimetry with a measurement range of 0-42 000. The primary outcome was CVD including coronary heart disease events and stroke events.
Results:
Among 8688 participants free from CVD (at baseline, mean age, 50.1 years, 3897 were males), there were 189 CVD events, occurred during a median follow-up of 6.34 years (54 685 person-years at risk). From the Kaplan-Meier curve, we found that there was a progressive increase in CVD event rates by hs-CRP tertiles (log-rank test, p<0.001). Baseline hs-CRP was linearly associated with CVD (p for trend=0.015) even after adjusting for known CVD risk factors. Furthermore, the net reclassification improvement when hs-CRP was added to a model based on traditional factors was 7.85% for CVD (p=0.003). In addition, the correlation between change of hs-CRP and CVD was conducted in a subgroup (n=4778). However, we did not find the correlation between hs-CRP change and CVD (correlation coefficient: -0.003, p=0.846).
Conclusions:
In the middle-aged Chinese population, hs-CRP was associated with increased risk of developing CVD. Although there was no correlation between hs-CRP change and CVD, the level of hs-CRP was higher at follow-up than baseline even among those with CVD. More attention should be given to those with higher level of hs-CRP for CVD prevention.
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