Implications of increased C-reactive protein for cardiovascular risk stratification in black and white men and women in the US.
Implications of increased C-reactive protein for cardiovascular risk stratification in black and white men and women in the US.
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DOI：
10.1373/clinchem.2008.122093
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发表时间：
2009-09
影响因子：
9.3
通讯作者：
Howard G
中科院分区：
文献类型：
--
作者：
Cushman M;McClure LA;Howard VJ;Jenny NS;Lakoski SG;Howard G
我们评估了大量黑人和白人中 C 反应蛋白 (CRP) 升高的患病率和相关性，以及 CRP 测量对冠心病 (CHD) 风险重新分类的影响。我们研究了中风地理和种族差异原因 (REGARDS) 研究的 19,080 名参与者；年龄超过 45 岁，没有血管诊断，并且居住在美国各地。 8,309 名未使用降脂药物的非糖尿病参与者被分为弗雷明汉血管疾病风险评分的四个风险类别。如果CRP<1毫克/升，参与者被重新分类到下一个较低风险组，如果>3毫克/升，他们被重新分类到下一个较高风险组。还评估了雷诺血管风险评分（结合 CRP 和家族史）对风险的重新分类。总体而言，40% 的 CRP >3 mg/L。 CRP 升高的风险最高的是黑人、女性和肥胖者。在弗雷明汉血管预测风险为 5-20% 的非糖尿病女性中，CRP 将 48% 重新分类为较高风险组，将 19% 重新分类为较低风险组。对于男性来说，这一比例分别为 24% 和 40%。与白人相比，黑人更常被重新分类为较高风险群体。雷诺兹血管风险评分将 85% 的女性和 67% 的男性重新分类，几乎完全属于比弗雷明汉血管评分更低的风险组。在这项全国性研究中，大多数人，尤其是黑人和女性，在风险评估后使用 CRP 测试被重新分类为不同的 10 年血管风险级别。雷诺风险评分对人群的分类与采用 CRP 测试的新弗雷明汉血管评分不同。
We evaluated prevalence and correlates of elevated C-reactive protein (CRP) in a large population of blacks and whites, and the impact of CRP measurement on coronary heart disease (CHD) risk reclassification. We studied 19,080 participants of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study; age over 45, without vascular diagnoses, and living dispersed across the United States. 8,309 nondiabetic participants not using lipid-lowering medications were classified into four risk categories of Framingham Vascular Disease Risk Score. If CRP was <1 mg/L, participants were reclassified to the next lower risk group and if >3 mg/L, they were reclassified to the next higher risk group. Reclassification of risk by the Reynolds Vascular Risk Score, incorporating CRP and family history, was also assessed. Overall, 40% had CRP >3 mg/L. Those at highest risk for elevated CRP were blacks, women and obese people. Among nondiabetic women at 5–20% Framingham Vascular predicted risk, CRP reclassified 48% to a higher risk group and 19% to a lower risk group. For men, these percentages were 24% and 40%. Blacks were more often reclassified to a higher risk group than whites. The Reynolds Vascular Risk Score reclassified 85% of women and 67% of men, almost exclusively to a lower risk group than the Framingham Vascular Score. In this national study, a majority, especially blacks and women, were reclassified to a different 10-year vascular risk level using CRP testing after risk assessment. The Reynolds Risk Score classified the population differently than the new Framingham Vascular Score with CRP testing.
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影响因子：
11.2
作者：
Cushman, Mary;Cantrell, Ronald A.;McClure, Leslie A.;Howard, George;Prineas, Ronald J.;Moy, Claudia S.;Temple, Ella M.;Howard, Virginia J.
通讯作者：
Howard, Virginia J.
影响因子：
37.8
作者：
Cushman, M;Arnold, AM;Tracy, RP
通讯作者：
Tracy, RP
影响因子：
37.8
作者：
Wilson, PWF;D'Agostino, RB;Kannel, WB
通讯作者：
Kannel, WB
影响因子：
4.8
作者：
Matthews, KA;Sowers, MF;Pasternak, RC
通讯作者：
Pasternak, RC
影响因子：
2.8
作者：
Albert, MA;Glynn, RJ;Ridker, PM
通讯作者：
Ridker, PM