Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly

作者：Russell P. Tracy, Rozenn N. Lemaître, Bruce M. Psaty, Diane G. Ives, Roger G. Evans, Mary Cushman, Elaine N. Meilahn, Lewis H. Kuller · 发表于：Arteriosclerosis Thrombosis and Vascular Biology · 年份：1997 · DOI：10.1161/01.atv.17.6.1121 · 被引用次数：843 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Lipoproteins and Cardiovascular Health、Cardiovascular Disease and Adiposity

Markers of inflammation, such as C-reactive protein (CRP), are related to risk of cardiovascular disease (CVD) events in those with angina, but little is known about individuals without prevalent clinical CVD. We performed a prospective, nested case-control study in the Cardiovascular Health Study (CHS; 5201 healthy elderly men and women). Case subjects (n = 146 men and women with incident CVD events including angina, myocardial infarction, and death) and control subjects (n = 146) were matched on the basis of sex and the presence or absence of significant subclinical CVD at baseline (average follow-up, 2.4 years). In women but not men, the mean CRP level was higher for case subjects than for control subjects (P < or = .05). In general, CRP was higher in those with subclinical disease. Most of the association of CRP with female case subjects versus control subjects was in the subgroup with subclinical disease; 3.33 versus 1.90 mg/L, P < .05, adjusted for age and time of follow-up. Case-control differences were greatest when the time between baseline and the CVD event was shortest. The strongest associations were with myocardial infarction, and there was an overall odds ratio for incident myocardial infarction for men and women with subclinical disease (upper quartile versus lower three quartiles) of 2.67 (confidence interval [CI] = 1.04 to 6.81), with the relationship being stronger in women (4.50 [CI = 0.97 to 20.8]) than in men (1.75 [CI = 0.51 to 5.98]). We performed a sim...