C-Reactive Protein and Other Markers of Inflammation in the Prediction of Cardiovascular Disease in Women

Ridker, Paul M.; Hennekens, Charles H.; Buring, Julie E.; Rifai, Nader

doi:10.1056/nejm200003233421202

Cited by 5,224 publications

(3,507 citation statements)

References 29 publications

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“…We now extend these findings to a wider age range, and show that soluble CD14 predicts incident HF and all‐cause and CVD mortality. sICAM1 is a cell adhesion molecule that previously has been associated with CVD, including myocardial infarction, in case‐control studies 33, 34. We now show that sICAM1 predicts not only ASCVD, but also all‐cause mortality and CVD mortality.…”

Section: Discussionsupporting

confidence: 54%

Protein Biomarkers of Cardiovascular Disease and Mortality in the Community

Lyass

Courchesne

et al. 2018

JAHA

200

212

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BackgroundThe discovery of novel and highly predictive biomarkers of cardiovascular disease (CVD) has the potential to improve risk‐stratification methods and may be informative regarding biological pathways contributing to disease.Methods and ResultsWe used a discovery proteomic platform that targeted high‐value proteins for CVD to ascertain 85 circulating protein biomarkers in 3523 Framingham Heart Study participants (mean age, 62 years; 53% women). Using multivariable‐adjusted Cox models to account for clinical variables, we found 8 biomarkers associated with incident atherosclerotic CVD, 18 with incident heart failure, 38 with all‐cause mortality, and 35 with CVD death (false discovery rate, q<0.05 for all; P‐value ranges, 9.8×10−34 to 3.6×10−2). Notably, a number of regulators of metabolic and adipocyte homeostasis were associated with cardiovascular events, including insulin‐like growth factor 1 (IGF1), insulin‐like growth factor binding protein 1 (IGFBP1), insulin‐like growth factor binding protein 2 (IGFBP2), leptin, and adipsin. In a multimarker approach that accounted for clinical factors, growth differentiation factor 15 (GDF15) was associated with all outcomes. In addition, N‐terminal pro‐b‐type natriuretic peptide, C‐reactive protein, and leptin were associated with incident heart failure, and C‐type lectin domain family 3 member B (CLEC3B; tetranectin), N‐terminal pro‐b‐type natriuretic peptide, arabinogalactan protein 1 (AGP1), soluble receptor for advanced glycation end products (sRAGE), peripheral myelin protein 2 (PMP2), uncarboxylated matrix Gla protein (UCMGP), kallikrein B1 (KLKB1), IGFBP2, IGF1, leptin receptor, and cystatin‐C were associated with all‐cause mortality in a multimarker model.ConclusionsWe identified numerous protein biomarkers that predicted cardiovascular outcomes and all‐cause mortality, including biomarkers representing regulators of metabolic homeostasis and inflammatory pathways. Further studies are needed to validate our findings and define clinical utility, with the ultimate goal of improving strategies for CVD prevention.

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Section: Discussionsupporting

confidence: 54%

Protein Biomarkers of Cardiovascular Disease and Mortality in the Community

Lyass

Courchesne

et al. 2018

JAHA

200

212

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“…Median interleukin‐6 concentrations in both cohorts were higher, as expected, than those seen in cohorts free of overt CVD, where baseline interleukin‐6 concentrations tend to average in the 1.3 to 1.6 pg/mL range 1, 2, 3. More surprising is that the median interleukin‐6 concentration in the SOLID‐TIMI 52 population of patients with recent ACS was similar to, and not higher than, that in the SOLID‐TIMI 52 population of patients with stable CHD (2.1 versus 2.0 pg/mL, respectively).…”

supporting

confidence: 64%

Pretenders and Contenders: Inflammation, C‐Reactive Protein, and Interleukin‐6

Daniels

2017

JAHA

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“…CRP can represent a marker for a pro‐inflammatory state, as it affects cardiovascular risk 45, 46, 47. Although women appear to have higher CRP levels than men, both rise progressively with increasing waist circumference.…”

Section: Discussionmentioning

confidence: 99%

Upper body fat predicts metabolic syndrome similarly in men and women

Grundy

Williams

Vega

2018

Eur J Clin Investigation

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BackgroundThe metabolic syndrome is a constellation of risk factors including dyslipidemia, dysglycemia, hypertension, a pro‐inflammatory state, and a prothrombotic state. All of these factors are accentuated by obesity. However, obesity can be defined by body mass index (BMI), percent body fat, or by body fat distribution. The latter consists of upper body fat (subcutaneous and visceral fat) and lower body fat (gluteofemoral fat). Waist circumference is a common surrogate marker for upper body fat.MethodsData from the National Health and Nutrition Examination Survey (NHANES) for the years 1999‐2006 was examined for associations of metabolic risk factors with percent body fat, waist circumference, and BMI.ResultsAssociations between absolute measures of waist circumference and risk factors were similiar for men and women. The similarities of associations between waist circumference and risk factors suggests that greater visceral fat in men does not accentuate the influence of upper body fat on risk factors.ConclusionsDifferent waist concumference values should not be used to define abdominal obesity in men and women.

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C-Reactive Protein and Other Markers of Inflammation in the Prediction of Cardiovascular Disease in Women

Abstract: The addition of the measurement of C-reactive protein to screening based on lipid levels may provide an improved method of identifying persons at risk for cardiovascular events.

Cited by 5,224 publications

References 29 publications

Protein Biomarkers of Cardiovascular Disease and Mortality in the Community

Protein Biomarkers of Cardiovascular Disease and Mortality in the Community

Pretenders and Contenders: Inflammation, C‐Reactive Protein, and Interleukin‐6

Upper body fat predicts metabolic syndrome similarly in men and women

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