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Association Between High-sensitivity C-reactive Protein and Predicted Cardiovascular Risks in Schizophrenia
Insights
High-sensitivity C-reactive protein (hs-CRP) can predict high cardiovascular risk in schizophrenia patients. An hs-CRP level of ≥2.13 mg/L is an independent predictor, aiding early identification of at-risk individuals.
Area of Science:
- Cardiology
- Psychiatry
- Biomarkers
Background:
- Cardiovascular disease (CVD) is a leading cause of premature mortality in schizophrenia patients.
- High-sensitivity C-reactive protein (hs-CRP) is a marker of subclinical inflammation and linked to CVD risk factors in the general population.
Purpose of the Study:
- To assess the predictive capability of hs-CRP for identifying high cardiovascular risk in individuals diagnosed with schizophrenia.
- To establish an optimal hs-CRP cutoff value for predicting high cardiovascular risk in this patient group.
Main Methods:
- A cross-sectional retrospective study was conducted with 387 schizophrenia patients.
- hs-CRP levels and 10-year general cardiovascular risk were measured. Receiver operating characteristic (ROC) curves and multivariate logistic regression were utilized.
Main Results:
- A hs-CRP cutoff value of 2.13 mg/L demonstrated fair discrimination for high cardiovascular risk (C statistic = 0.74).
- An hs-CRP level of ≥2.13 mg/L was independently associated with high cardiovascular risk (OR = 7.81, P = .008) after adjusting for confounders.
Conclusions:
- Elevated hs-CRP (≥2.13 mg/L) serves as an independent predictor of high cardiovascular risk in schizophrenia patients.
- Measuring hs-CRP may assist in identifying schizophrenia patients at elevated risk for cardiovascular events, warranting further prospective research.
Context:
Cardiovascular disease (CVD) is one of the main causes of premature death in patients with schizophrenia. High-sensitivity C-reactive protein (hs-CRP) is closely related to various risk factors of CVD in the general population and is a sensitive marker of subclinical inflammation.
Objectives:
The study intended to evaluate the predictive value of hs-CRP for high cardiovascular risk in patients with schizophrenia.
Design:
The research team designed a cross-sectional retrospective study.
Setting:
The study took place at the Affiliated Brain Hospital of Guangzhou Medical University in Guangzhou, Guangdong Province, China.
Participants:
Participants were 387 patients with schizophrenia who had been admitted to the inpatient clinic at the hospital between January 1, 2018 and December 30, 2019.
Outcome Measures:
The research team: (1) measured participants' hs-CRP and calculated the 10-year general cardiovascular risk, with a risk of >20% being defined as a high risk; (2) compared participants' demographics and traditional cardiovascular risk factors, and the prevalence of high cardiovascular risk according to the hs-CRP quartile; (3) used the receiver operating characteristic (ROC) curves to determine the optimal cutoff value for hs-CRP to predict high cardiovascular risk; and (4) used multivariate logistic regression analysis to assess the association between hs-CRP and high cardiovascular risk.
Results:
Of the 387 participants, 23 had a high cardiovascular risk (5.9%). The prevalence of high cardiovascular risk in quartiles Q1, Q2, Q3, and Q4 groups was 0%, 2.0%, 12.5%, and 9.4%, respectively, with a P trend < .001. The ROC analysis showed that an hs-CRP cutoff value of 2.13mg/L was a fair discriminator for high cardiovascular risk, with a C statistic of 0.74. After adjusting confounding factors by multivariate logistic regression analysis, an hs-CRP of ≥2.13 mg/L was significantly associated with high cardiovascular risk (OR = 7.81, 95% CI: 1.73 - 35.39, P = .008).
Conclusions:
An hs-CRP of ≥2.13 mg/L can be an independent predictor of high cardiovascular risk in patients with schizophrenia. Detection of hs-CRP may be beneficial in identifying patients at high risk of cardiovascular events in this population. Further prospective studies are needed to determine the hs-CRP threshold for evaluating cardiovascular risk in schizophrenia.
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