High Sensitivity C-reactive Protein: An Emerging Role in Cardiovascular Risk Assessment

Benzaquen, Laura R.; Yu, Harry H.; Rifai, Nader

doi:10.1080/10408360290795556

Cited by 52 publications

(30 citation statements)

References 144 publications

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“…This suggests that it is specifically CRP (or something closely associated with it) that is responsible for the link between RA and CVD. These data add to the studies showing that modest elevations in the CRP concentration in apparently healthy adults are associated with subsequent cardiovascular events (18,25). The finding that a CRP concentration above the normal range is a significant predictor of death from CVD in groups of patients with inflammatory joint disease provides further evidence for the role of inflammation in promoting atherosclerotic disease.…”

Section: Discussionsupporting

confidence: 57%

Baseline levels of c‐reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis : A ten‐year followup study of a primary care–based inception cohort

Goodson

Symmons

Scott

et al. 2005

Arthritis & Rheumatism

262

141

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Objective. To test the hypothesis that the C-reactive protein (CRP) concentration at baseline is an independent predictor of death from cardiovascular disease (CVD) in newly diagnosed patients with inflammatory polyarthritis (IP).Methods. Patients with IP (n ‫؍‬ 506) who were recruited from the Norfolk Arthritis Register between 1990 and 1992 were followed up to the end of 2001, and complete data on mortality were obtained. At baseline, subjects underwent a structured interview and joint examination and completed a Health Assessment Questionnaire (HAQ). Blood was obtained and analyzed for rheumatoid factor (RF) and CRP concentration. Cox regression was used to calculate hazards ratios (HRs) for risk of death from CVD.Results. The median followup was 10.1 years (interquartile range 9.3-10.8). There were 104 deaths, 40 of which were the result of CVD. Elevated CRP levels (>5 mg/liter) predicted death from CVD in univariate analyses: HR 3.9 (95% confidence interval [95% CI] 1.2-13.4) for men, and HR 4.22 (95% CI 1.4-12.6) for women. After adjusting for age and sex, the CVD mortality association was strongest in the subgroup of patients who were RF positive at baseline (adjusted HR 7.4 [95% CI 1.7-32.2]). Multivariate analysis revealed that elevated CRP levels remained a significant independent predictor of death from CVD, even after adjusting for age, sex, smoking status, HAQ score, RF positivity, and swollen joint counts (HR 3.3 [95% CI 1.4-7.6]).Conclusion. The CRP concentration at baseline is an important predictor of subsequent death from CVD in patients with new-onset IP and is independent of other indicators of disease severity. This supports the theory that CRP may play a direct role in the pathogenesis of CVD.

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Section: Discussionsupporting

confidence: 57%

Baseline levels of c‐reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis : A ten‐year followup study of a primary care–based inception cohort

Goodson

Symmons

Scott

et al. 2005

Arthritis & Rheumatism

262

141

View full text Add to dashboard Cite

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“…The association of relatively high CRP levels with active coronary disease was well known, but after the development of highly sensitive assays for CRP—hsCRP assays—increasing risk became apparent within ranges that were previously considered normal. These hsCRP assays allow the reliable measurement of levels of CRP as low as 0.1 mg/dl (18). Standardization of hsCRP assays is relatively more advanced than for other markers, and CRP remains stable without the need for freezing.…”

Section: Inflammatory Biomarkers As Risk Predictors In Cvdmentioning

confidence: 99%

UNRESOLVED ISSUES IN DIALYSIS: Inflammatory Biomarkers and Cardiovascular Risk: Association or Cause and Effect?

Madhumathi

Jaber

Balakrishnan

2006

Seminars in Dialysis

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With the current understanding that atherosclerosis is an inflammatory disorder, markers of the associated systemic inflammatory response have been extensively studied as predictors of cardiovascular disease. Recently the use of high-sensitivity C-reactive protein (hsCRP) has been proposed for risk assessment in individuals at intermediate risk of coronary heart disease. The traditional view of inflammatory biomarkers, including CRP, regards them as risk markers rather than risk factors. Either category of marker would serve a diagnostic role, monitor disease activity, and indicate the efficacy of therapy or changing prognosis. However a risk factor with a causal role would be a potential target for therapy. This review discusses the available evidence that argues for and against a causal role for inflammatory biomarkers, with specific reference to CRP, in the atherosclerotic process.

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“…Imaging, although effective, is an expensive technique (3,4). While C-reactive protein (5,6) and oxidized low-density lipoprotein (oxidized LDL) 1 (7,8) are both gaining attention as independent biomarkers (risk predictors) of atherosclerotic events, neither have been widely embraced and utilized clinically as diagnostics of vessel wall lesions, lesion stability, or lesion load. Therefore, much work remains to be done to find a true pharmacodynamic marker of atherosclerosis (as opposed to hypercholesterolemia) that could be used in clinical trials of anti-atherosclerotic compounds (9).…”

mentioning

confidence: 99%

In Vitro Biomarker Discovery for Atherosclerosis by Proteomics

Fach

Garulacan

Gao

et al. 2004

Molecular & Cellular Proteomics

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The purpose of this study was to identify in vitro and then prioritize a tractable set of protein biomarker candidates of atherosclerosis that may eventually be developed to measure the extent, progression, regression, and stability of atherosclerotic lesions. A study was conducted using an in vitro "foam cell" model based on the stimulation of differentiated THP1 cells with oxidized low-density lipoprotein (oxidized LDL) as compared with low-density lipoprotein (LDL). Analysis of the proteins contained in the cell supernatant using proteome scanning technology identified 59 proteins as being increased, 57 with no statistically measurable difference, and 17 decreasing in abundance following treatment with oxidized LDL, as compared with LDL. From the up-regulated list, proteins were prioritized based on their analytical confidence as well as their relevance to atherosclerosis pathways. Within the group of increased abundance, seven families of proteins were of particular interest: fatty acid-binding proteins, chitinase-like enzymes, cyclophilins, cathepsins, proteoglycans, urokinase-type plasminogen activator receptor, and a macrophage scavenger receptor.

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High Sensitivity C-reactive Protein: An Emerging Role in Cardiovascular Risk Assessment

Cited by 52 publications

References 144 publications

Baseline levels of c‐reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis : A ten‐year followup study of a primary care–based inception cohort

Baseline levels of c‐reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis : A ten‐year followup study of a primary care–based inception cohort

UNRESOLVED ISSUES IN DIALYSIS: Inflammatory Biomarkers and Cardiovascular Risk: Association or Cause and Effect?

In Vitro Biomarker Discovery for Atherosclerosis by Proteomics

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