What Is C-Reactive Protein Telling Us About Coronary Artery Disease?

Levinson, Stanley S.; Elin, Ronald J.

doi:10.1001/archinte.162.4.389

Cited by 29 publications

(10 citation statements)

References 29 publications

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“…26 Because CRP is an acute-phase reactant that increases with any tissue injury or infection, it does not discriminate between cardiac and noncardiac processes. 26 However, chronic inflammation, as indicated by high concentrations of C-reactive protein, is associated with an increased risk of future coronary events. Table 1 were entered into a backwards elimination logistic regression model including the 5 CRP categories.…”

Section: Discussionmentioning

confidence: 99%

C-Reactive Protein and Ischemia in Users and Nonusers of β-Blockers and Statins

et al. 2003

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Background-Elevated levels of C-reactive protein (CRP) are associated with an increased risk of coronary events, but whether inflammation is associated with inducible ischemia in patients with stable coronary disease is unknown. Methods and Results-We recruited patients with known coronary disease from 2 VA Medical Centers and 1 University-based medical center for the Heart and Soul Study. We measured CRP levels in 118 participants who had exercise-induced ischemia and in 111 who did not have inducible ischemia, as determined by stress echocardiography. We used logistic regression to examine the risk of exercise-induced ischemia associated with elevated CRP. We found that 75% (39/52) of participants in the highest CRP category (Ͼ0.38 mg/dL) had inducible ischemia, compared with 45% (79/177) in the lower 4 categories combined (adjusted odds ratio 4.2; 95% confidence interval 1.6 to 11; Pϭ0.004). However, this association differed in users and nonusers of ␤-blockers and statins. Among 89 participants who did not use ␤-blockers, 93% in the highest CRP category had exercise-induced ischemia, compared with 42% in the lower 4 categories (Pϭ0.03). Among 67 participants who did not use statins, 94% in the highest CRP category had exercise-induced ischemia, compared with 44% in the lower 4 categories (Pϭ0.009). We did not observe a significant association between CRP and ischemia among participants who were treated with either of these medications. Conclusion-Elevated

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Section: Discussionmentioning

confidence: 99%

C-Reactive Protein and Ischemia in Users and Nonusers of β-Blockers and Statins

et al. 2003

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“…Age, 53 gender, 54 obesity, 55 and smoking 56 are all associated with increased CRP levels. 52 Because CRP levels also increase with acute infection or trauma, they should not be assayed during such periods, possibly compromising their clinical usefulness. 54 Similar concerns were voiced by Kushner and Sehgal, 31 who reviewed application of the high-sensitivity CRP assay that has been more widely used in studies of CVD risk assessment in apparently healthy populations.…”

Section: Limitations Of C-reactive Protein As a Risk Markermentioning

confidence: 99%

New Clinical Markers Predictive of Cardiovascular Disease

Rackley

2004

Cardiology in Review

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Identification of persons at risk for developing cardiovascular disease has focused attention on blood pressure, smoking, and serum cholesterol levels. Modification of these factors has resulted in reduction of overall morbidity and mortality within the population. While significant, these risk factors do not predict all cardiovascular events, because the causes of cardiovascular disease are multifactorial and the risk associated with any given factor is compounded by the presence of other risk factors. Additional risk factors that may also identify risk for cardiovascular disease may include inflammatory mediators such as C-reactive protein, interleukin 6, cell adhesion molecules, and fibrinogen. Although additional studies are needed to establish the clinical utility of these markers, they may improve the identification and assessment of patients at risk for future cardiovascular events.

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“…In addition, many investigators have cautioned against the use of CRP because of its lack of specificity and lack in meeting the criteria proposed by the Guide to Clinical Prevention Services [34,35]. Furthermore, as CRP levels are affected by many inflammatory conditions, it has been cautioned that its predictive value in large epidemiologic studies may not translate to the individual patient.…”

Section: C-reactive Protein As a Therapeutic Targetmentioning

confidence: 99%

Inflammatory and oxidative markers in atherosclerosis: Relationship to outcome

Shishehbor

Hazen

2004

Curr Atheroscler Rep

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Inflammation and oxidative processes are key components of atherosclerosis, from fatty streak formation to plaque rupture and thrombosis. Recent basic and clinical studies have identified a number of inflammatory and oxidative processes that appear to play a direct role in atherothrombosis and identify potentially clinically useful markers of inflammation and oxidative stress. In this review, we highlight recent results on several of the more promising markers of inflammation for cardiovascular disease risk assessments, such as C-reactive protein, myeloperoxidase, and soluble CD40 ligand and nitrotyrosine, as well as other potential markers.

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What Is C-Reactive Protein Telling Us About Coronary Artery Disease?

Cited by 29 publications

References 29 publications

C-Reactive Protein and Ischemia in Users and Nonusers of β-Blockers and Statins

C-Reactive Protein and Ischemia in Users and Nonusers of β-Blockers and Statins

New Clinical Markers Predictive of Cardiovascular Disease

Inflammatory and oxidative markers in atherosclerosis: Relationship to outcome

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