High-Sensitivity C-Reactive Protein, Vascular Imaging, and Vulnerable Plaque

Ridker, Paul M.

doi:10.1161/circimaging.111.965053

Cited by 11 publications

(5 citation statements)

References 39 publications

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“…Another surprising finding is the high costs (~$5,000) associated with high-risk hsCRP. Certainly, the epidemiological data support an elevated CVD risk that would increase hospitalization and revascularization costs (25–27). Analyses also detailed higher costs for CVD medications among those with hsCRP >3 mg/l, which was likely influenced by trial evidence of therapeutic risk reduction with statin therapy (28).…”

Section: Discussionmentioning

confidence: 99%

10-Year Resource Utilization and Costs for Cardiovascular Care

Shaw

Goyal

Mehta

et al. 2018

Journal of the American College of Cardiology

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Section: Discussionmentioning

confidence: 99%

10-Year Resource Utilization and Costs for Cardiovascular Care

Shaw

Goyal

Mehta

et al. 2018

Journal of the American College of Cardiology

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“…Many population-based studies in subjects free of known CAD have found that CRP adds to risk prediction above standard risk factor assessment (23,24). However, results remain unclear in patients with CAD.…”

Section: Discussionmentioning

confidence: 99%

Aggregate Risk Score Based on Markers of Inflammation, Cell Stress, and Coagulation Is an Independent Predictor of Adverse Cardiovascular Outcomes

Eapen

Manocha

Patel

et al. 2013

Journal of the American College of Cardiology

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Objectives This study sought to determine an aggregate, pathway-specific risk score for enhanced prediction of death and myocardial infarction (MI). Background Activation of inflammatory, coagulation, and cellular stress pathways contribute to atherosclerotic plaque rupture. We hypothesized that an aggregate risk score comprised of biomarkers involved in these different pathways—high-sensitivity C-reactive protein (CRP), fibrin degradation products (FDP), and heat shock protein 70 (HSP70) levels—would be a powerful predictor of death and MI. Methods Serum levels of CRP, FDP, and HSP70 were measured in 3,415 consecutive patients with suspected or confirmed coronary artery disease (CAD) undergoing cardiac catheterization. Survival analyses were performed with models adjusted for established risk factors. Results Median follow-up was 2.3 years. Hazard ratios (HRs) for all-cause death and MI based on cutpoints were as follows: CRP ≥3.0 mg/l, HR: 1.61; HSP70 >0.625 ng/ml, HR; 2.26; and FDP ≥1.0 μg/ml, HR: 1.62 (p < 0.0001 for all). An aggregate biomarker score between 0 and 3 was calculated based on these cutpoints. Compared with the group with a 0 score, HRs for all-cause death and MI were 1.83, 3.46, and 4.99 for those with scores of 1, 2, and 3, respectively (p for each: <0.001). Annual event rates were 16.3% for the 4.2% of patients with a score of 3 compared with 2.4% in 36.4% of patients with a score of 0. The C statistic and net reclassification improved (p < 0.0001) with the addition of the biomarker score. Conclusions An aggregate score based on serum levels of CRP, FDP, and HSP70 is a predictor of future risk of death and MI in patients with suspected or known CAD.

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“…However, several recent reports have generated some controversy around data regarding its pertinence as a reliable biomarker in atherosclerosis [18]. Indeed, despite several population-based studies in subjects free of known CVD have shown the superiority of hsCRP above standard risk factors for risk prediction [19], other studies reported very limited contribution of hsCRP to CVD risk prediction [20]. In addition, Animal and human genetic reports have questioned the direct atherogenic effects of hsCRP, highlighting the lack of causal relationship between hsCRP and atherosclerosis [18, 21].…”

Section: Introductionmentioning

confidence: 99%

DUSP1 Is a Potential Marker of Chronic Inflammation in Arabs with Cardiovascular Diseases

et al. 2018

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Background Cardiovascular disease (CVD) risks persist in patients despite the use of conventional treatments. This might be due to chronic inflammation as reflected in epidemiological studies associating circulating low-grade inflammatory markers with CVD recurrent events. Here, we explored this potential link by assessing plasma dual-specificity phosphatase 1 (DUSP1) levels and comparing them to high-sensitivity CRP (hsCRP) and oxidized low-density lipoprotein (oxLDL) levels and their associations to conventional CVD risk factors in confirmed CVD patients. Methods Human adults with reported CVD (n = 207) and controls (n = 70) living in Kuwait were used in this study. Anthropometric and classical biochemical parameters were determined. Plasma levels of DUSP1, oxLDL, and hsCRP were measured using human enzyme-linked immunosorbent assay kits. Results DUSP1 and hsCRP plasma levels and their least square means were higher in CVD cases, while oxLDL plasma levels were lower (p < 0.05). Multivariate logistic regression analysis showed that DUSP1 and hsCRP are independently associated with CVD in the studied population, as reflected by 2-fold and 1.5-fold increased risks with increased levels of DUSP1 and hsCRP, respectively. In our study, DUSP1 levels were found to be associated with CVD despite statin treatment and diabetes status (p < 0.05), whereas hsCRP mainly correlated with obesity markers. Conclusions Circulating DUSP1 might be a predictor of chronic subclinical inflammation and residual risk in CVD patients, whereas our data suggest that the association between hsCRP and CVD is largely accounted for adiposity risk factors.

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High-Sensitivity C-Reactive Protein, Vascular Imaging, and Vulnerable Plaque

Cited by 11 publications

References 39 publications

10-Year Resource Utilization and Costs for Cardiovascular Care

10-Year Resource Utilization and Costs for Cardiovascular Care

Aggregate Risk Score Based on Markers of Inflammation, Cell Stress, and Coagulation Is an Independent Predictor of Adverse Cardiovascular Outcomes

DUSP1 Is a Potential Marker of Chronic Inflammation in Arabs with Cardiovascular Diseases

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