Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.
Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.
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DOI：
10.1056/nejmoa021993
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发表时间：
2002-11-14
影响因子：
158.5
通讯作者：
Cook, NR
中科院分区：
文献类型：
--
作者：
Ridker, PM;Rifai, N;Cook, NR
背景：c反应蛋白和低密度脂蛋白（LDL）胆固醇水平在有心血管事件风险的人群中升高。然而，直接比较这两种生物标志物的基于人群的数据是不可用的。方法：对27,939名表面健康的美国女性进行基线c反应蛋白和LDL胆固醇的测量，然后对她们进行平均8年的心肌梗死、缺血性卒中、冠状动脉血运重建术或心血管原因死亡的随访。我们评估了这两种测量方法在预测研究人群心血管事件风险方面的价值。结果：尽管c反应蛋白和低密度脂蛋白胆固醇的相关性很小（r=0.08），但两者的基线水平与心血管事件的发生率有很强的线性关系。在调整了年龄、吸烟状况、有无糖尿病、血压分类水平、使用或不使用激素替代治疗等因素后，与最低五分位数的女性相比，c反应蛋白升高四分位数的女性发生首次心血管事件的相对风险分别为1.4、1.6、2.0和2.3
Background: Both C-reactive protein and low-density lipoprotein (LDL) cholesterol levels are elevated in persons at risk for cardiovascular events. However, population-based data directly comparing these two biologic markers are not available.Methods: C-reactive protein and LDL cholesterol were measured at base line in 27,939 apparently healthy American women, who were then followed for a mean of eight years for the occurrence of myocardial infarction, ischemic stroke, coronary revascularization, or death from cardiovascular causes. We assessed the value of these two measurements in predicting the risk of cardiovascular events in the study population.Results: Although C-reactive protein and LDL cholesterol were minimally correlated (r=0.08), base-line levels of each had a strong linear relation with the incidence of cardiovascular events. After adjustment for age, smoking status, the presence or absence of diabetes mellitus, categorical levels of blood pressure, and use or nonuse of hormone-replacement therapy, the relative risks of first cardiovascular events according to increasing quartiles of C-reactive protein, as compared with the women in the lowest quintile, were 1.4, 1.6, 2.0, and 2.3 (P