Prospective Study of C-Reactive Protein and the Risk of Future Cardiovascular Events Among Apparently Healthy Women

Abstract

Background-C-reactive protein (CRP) predicts risk of myocardial infarction (MI) and stroke among apparently healthy men, but in women, virtually no data are available. Methods and Results-CRP was measured in baseline blood samples from 122 apparently healthy participants in the Women's Health Study who subsequently suffered a first cardiovascular event and from 244 age-and smoking-matched control subjects who remained free of cardiovascular disease during a 3-year follow-up period. Women who developed cardiovascular events had higher baseline CRP levels than control subjects (Pϭ0.0001), such that those with the highest levels at baseline had a 5-fold increase in risk of any vascular event (RRϭ4.8; 95% CI, 2.3 to 10.1; Pϭ0.0001) and a 7-fold increase in risk of MI or stroke (RRϭ7.3; 95% CI, 2.7 to 19.9; Pϭ0.0001). Risk estimates were independent of other risk factors, and prediction models that included CRP provided a better method to predict risk than models that excluded CRP (all P values Ͻ0.01). In stratified analyses, CRP was a predictor among subgroups of women with low as well as high risk as defined by other cardiovascular risk factors. Conclusions-In these prospective data among women, CRP is a strong independent risk factor for cardiovascular disease that adds to the predictive value of risk models based on usual factors alone. (Circulation. 1998;98:731-733.)

C‐Reactive Protein Identifies Low‐Risk Metabolically Healthy Obese Persons: The European Prospective Investigation of Cancer–Norfolk Prospective Population Study

“…We found similar associations for abdominally obese participants with elevated CRP levels showing an increased risk for CHD compared with abdominally obese participants with low CRP levels. Previous studies linking CRP levels to CHD were performed largely in populations with a lower prevalence of obesity than that of the current US population 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32. In the 2 largest published studies of CRP and CHD disease,25, 27 the mean body mass index (in  kg/m 2 ) of participants ranged from 25 to 26, lower than the recently reported mean of 28.7 in US adults,33 indicating the clinical need for data regarding CRP in obese populations.…”

Incidence of noncardiac vascular disease in rheumatoid arthritis and relationship to extraarticular disease manifestations

“…However, accumulating evidence indicates that inflammation is important in the pathogenesis of atherosclerosis. Inflammatory biomarkers, such as elevated levels of high-sensitivity C-reactive protein, are predictive of the occurrence of myocardial infarction (32,33) and also of peripheral vascular disease (34) in the general population. In patients with RA, a higher erythrocyte sedimentation rate has been reported to be predictive of cardiovascular comorbidity (35).…”

Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus

“…For people without diabetes, total dietary fiber intake is recommended to be 14 g/1000 kcal each day, including soluble and insoluble fibers [34]; the recommended intake is higher for individuals with diabetes [11,32]. Dietary fiber intake is inversely associated with levels of C-reactive protein [35], a marker of inflammation predicting future coronary heart disease (CHD) [36][37][38][39][40]. Soluble fiber is also of benefit in lowering low-density lipoprotein cholesterol and is mainly found in whole grains such as barley and oats and in legumes, fruits, vegetables, nuts, and ground flax seeds.…”