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High Sensitivity C-Reactive Protein Predictive Value for Cardiovascular Disease: A Nested Case Control from Isfahan
Pooya Koosha1, Hamidreza Roohafza2, Nizal Sarrafzadegan3
1Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR.
Insights
Assessing high-sensitivity C-reactive protein (hs-CRP) aids in predicting cardiovascular diseases (CVDs) for individuals with hypertension, diabetes, lipid abnormalities, or a smoking history. This marker offers valuable insights into cardiovascular risk stratification.
Area of Science:
- Cardiology
- Biomarkers
- Public Health
Background:
- High-sensitivity C-reactive protein (hs-CRP) is an established independent risk factor for cardiovascular diseases (CVDs).
- Understanding the predictive value of hs-CRP across diverse cardiovascular risk factor profiles is crucial for risk stratification.
Purpose of the Study:
- To investigate the clinical utility of assessing hs-CRP in individuals with various cardiovascular risk factors.
- To determine if hs-CRP levels enhance CVD prediction in specific patient subgroups.
Main Methods:
- A nested case-control study design was employed within the Isfahan Cohort Study (ICS).
- Cases comprised individuals diagnosed with CVDs (myocardial infarction, stroke, etc.), while controls were matched without these conditions.
- hs-CRP levels were analyzed in four quartiles to calculate odds ratios (OR) for CVD prediction across different risk factor categories.
Main Results:
- All hs-CRP quartiles indicated an increased likelihood of CVDs in patients with diabetes mellitus (DM) and hypertension (HTN).
- Elevated hs-CRP levels, particularly in the second quartile, were associated with significantly higher risks of CVDs in individuals with hypertriglyceridemia and dyslipidemia.
- The fourth quartile of hs-CRP demonstrated significant associations with increased CVD risk in patients with hypercholesterolemia, high LDL-C, and hypertriglyceridemia. Smokers in the third quartile also showed heightened CVD risk.
Conclusions:
- Assessing hs-CRP is beneficial for predicting CVDs in patients diagnosed with hypertension (HTN) and diabetes mellitus (DM).
- Individuals with specific lipid abnormalities (dyslipidemia, hypercholesterolemia, high LDL-C, hypertriglyceridemia) and a history of smoking can benefit from hs-CRP assessment for improved CVD risk evaluation.
Background:
High sensitivity C-reactive protein (hs-CRP) was proven to be an independent risk factor for cardiovascular diseases (CVDs). The aim of this study was to investigate the benefits of assessing hs-CRP among individuals with different cardiovascular risk factors.
Methods:
This nested case-control study was obtained from the Isfahan Cohort Study (ICS). Anyone who has been suffering from any CVDs, including myocardial infarction, unstable angina, sudden cardiac death and stroke was put in the case group. Density sampling method was utilized to choose the control group who had no aforementioned CVDs during follow-up. Four quartiles of hs-CRP (Q1: 0.1-2.3, Q2: 2.4-3, Q3: 3.1-4 and Q4: 4.1-14 mg/l) were assessed defining odds ratios (OR) of CVDs prediction in different CVDs risk factor categories. Confidence intervals of 95% are put in brackets.
Results:
A total of 502 cases and 538 controls were recruited. All hs-CRP quartiles showed increased CVDs likelihood compared to normal subjects in terms of diabetes mellitus (DM) and hypertension (HTN). Second quartile showed a 1.93 [1.33-2.81] and 3.34 [1.36-8.17] increased risks in patients with hypertriglyceridemia or dyslipidemia, respectively. Smokers in the third quartile group revealed increased CVDs risk. The fourth quartile showed significant increased risks in patients suffering from hypercholesterolemia (OR = 1.91 [1.33-2.74]), high LDL-C (OR = 1.88 [1.33-2.66]), and hypertriglyceridemia (OR = 2.31 [1.57-3.41]).
Conclusions:
Our findings suggested that assessing hs-CRP is beneficial for predicting CVDs in patients with HTN and DM. Furthermore, specific patients with lipid abnormalities or history of smoking benefits from checking hs-CRP.
