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CRP Cutoff Value in East Asians With Coronary Heart Disease: A Systematic Review and Meta-Analysis
Yu-Yan Xiong1, Miao Yu1, Qi Long1
1Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Provincial Engineering Research Center of Immunological Diagnosis and Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Biological Targeted Therapy (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, China.
Insights
C-reactive protein (CRP) levels in East Asian coronary heart disease (CHD) patients are lower than in Western populations. A CRP level of 1.0 mg/L or higher effectively predicts poor prognosis in these patients.
Area of Science:
- Cardiology
- Inflammation Biomarkers
- Epidemiology
Background:
- C-reactive protein (CRP) is a known prognostic marker in Western coronary heart disease (CHD) patients.
- East Asian populations exhibit lower baseline CRP levels, necessitating specific evaluation.
- Understanding CRP's role in East Asian CHD is crucial for risk stratification.
Purpose of the Study:
- To determine the inflammatory risk cutoff value of CRP in East Asian CHD patients.
- To analyze the association between CRP levels and major adverse cardiovascular events (MACE) in this population.
Main Methods:
- Systematic review and meta-analysis of studies from PubMed, Embase, Cochrane Library, and Scopus.
- Inclusion of studies reporting CRP levels and MACE incidence (all-cause death, myocardial infarction, stroke, revascularization).
- Data analysis from eight studies involving 21,455 patients.
Main Results:
- Elevated CRP levels significantly correlated with increased MACE risk (RR: 1.41, 95% CI: 1.22-1.63).
- Median CRP level in East Asian CHD patients was 1.2 mg/L, lower than Western cohorts.
- A CRP threshold of ≥1.0 mg/L, not ≥2.0 mg/L, better predicted poor prognosis.
Conclusions:
- The median CRP level in East Asian CHD patients is 1.2 mg/L.
- A CRP level of ≥1.0 mg/L is an appropriate indicator of inflammatory risk.
- CRP ≥1.0 mg/L serves as a suitable predictor of poor prognosis in East Asian CHD patients.
Background:
Although abundant data support an association between C-reactive protein (CRP) concentration and poor prognosis in coronary heart disease (CHD) patients in Western countries, East Asian populations with lower baseline CRP levels require further comprehensive evaluation.
Objectives:
This systematic review and meta-analysis aimed to clarify the inflammatory risk cutoff value of CRP level in East Asian CHD patients and the association between CRP level and the risk of major adverse cardiovascular events (MACE).
Methods:
We conducted a systematic review by searching PubMed, Embase, Cochrane Library, and Scopus from their inception to June 7, 2025. Studies that met the criteria reported the association between CRP level and incidence of MACE, a composite of all-cause death, myocardial infarction, stroke, and revascularization.
Results:
Eight studies, which collectively involved 21,455 patients, met the inclusion criteria. Elevated CRP levels were found to be notably associated with an increased MACE risk (RR: 1.41, 95% CI: 1.22-1.63; P < 0.00001; I2 = 69%). Subgroup analysis further revealed that the median CRP level in East Asian CHD patients was 1.2 mg/L, which was much lower than that in Western populations. Moreover, the CRP level ≥1.0 mg/L rather than ≥2.0 mg/L better predicted poor prognosis in East Asian patients.
Conclusions:
This meta-analysis indicates that the median CRP level among East Asian CHD patients is 1.2 mg/L. Furthermore, a CRP level ≥1.0 mg/L can appropriately define inflammatory risk and serves as a suitable predictor of poor prognosis in East Asian CHD patients.
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