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Association between high-sensitivity C-reactive protein and coronary atherosclerosis in a general middle-aged

Sofia Cederström1, Pia Lundman2, Joakim Alfredsson3

  • 1Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. sofia.cederstrom@ki.se.

Scientific Reports
|July 27, 2023
PubMed

Insights

Systemic inflammation, measured by high-sensitivity C-reactive protein (hsCRP), shows a weak association with coronary atherosclerosis in the general population. Elevated hsCRP is linked to noncalcified plaques, but its additional value beyond traditional risk factors for detecting coronary atherosclerosis is low.

Area of Science:

  • Cardiovascular Medicine
  • Inflammation Research
  • Biomarker Analysis

Background:

  • The link between inflammation and coronary atherosclerosis is established, but the role of systemic inflammation markers like hsCRP in the general population remains unclear.
  • High-sensitivity C-reactive protein (hsCRP) is a marker of systemic inflammation.
  • Coronary atherosclerosis is a significant public health concern.

Purpose of the Study:

  • To investigate the association between hsCRP levels and coronary atherosclerosis detected by coronary computed tomography angiography (CCTA).
  • To evaluate the added value of hsCRP to traditional risk factors in identifying coronary atherosclerosis.

Main Methods:

  • A population-based cohort study (SCAPIS) involving 25,408 individuals aged 50-64 years.
  • Coronary atherosclerosis was assessed using CCTA, defined by plaque presence in coronary segments.
  • hsCRP levels were measured and categorized, with statistical adjustments for age, sex, traditional risk factors, and BMI.

Main Results:

  • Elevated hsCRP (≥2.3 mg/L) showed a weak association with any coronary atherosclerosis, significant stenosis (≥50%), and involvement of ≥4 segments.
  • Associations were attenuated after adjusting for BMI, but elevated hsCRP remained linked to noncalcified plaques.
  • The predictive value of hsCRP for coronary atherosclerosis, beyond traditional risk factors, was found to be low.

Conclusions:

  • hsCRP has limited additional value in detecting coronary atherosclerosis when traditional risk factors are considered.
  • The association between hsCRP and noncalcified plaques may partially explain its link to clinical coronary events, though a direct causal pathway is unlikely.
  • Further research may clarify the role of hsCRP in specific plaque types and clinical outcomes.

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