C-reactive protein and the 10-year incidence of coronary heart disease in older men and women - The cardiovascular health study
C-reactive protein and the 10-year incidence of coronary heart disease in older men and women - The cardiovascular health study
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DOI：
10.1161/circulationaha.104.504159
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发表时间：
2005-07-05
期刊：
影响因子：
37.8
通讯作者：
Tracy, RP
中科院分区：
文献类型：
--
作者：
Cushman, M;Arnold, AM;Tracy, RP
背景-高C反应蛋白（CRP）与冠心病风险增加有关。方法和结果：在3971名年龄>= 65岁且既往无血管疾病的男性和女性中测量了基线CRP; 26%的患者浓度升高（> 3 mg/ L）。在10年的随访中，547名参与者发生了冠心病（CHD;定义为心肌梗死或冠状动脉死亡）。随着CRP升高，10年累积CHD发病率男性为33%，女性为17%。CRP > 3 mg/ L与< 1 mg/L相比，经年龄、种族和性别校正的CHD相对危险度为1.82（95%CI，1.46 - 2.28）。调整传统危险因素后，相对危险度降至1.45（95%CI，1.14 - 1.86）。人群归因于CRP升高的CHD风险为11%。在由基线风险因素定义的亚组中，风险关系没有差异。我们评估了CRP是否能通过Fragrance风险评分改善预测。在10年Framingham预测风险为10%至20%的男性中，观察到CRP升高的CHD发病率为32%。在女性中，CRP最好的区别与10年的预测风险> 20%;发病率分别为31%和10%的CRP水平升高和正常，respectively.Conclusions -在老年男性和女性，CRP升高与冠心病的10年风险增加，无论是否存在心脏危险因素。一个单一的CRP测量提供的信息超出了传统的风险评估，特别是在中等风险的男性和高风险的女性。
Background - High C-reactive protein (CRP) is associated with increased coronary heart disease risk. Few long-term data in the elderly are available.Methods and Results - Baseline CRP was measured in 3971 men and women >= 65 years of age without prior vascular diseases; 26% had elevated concentrations ( > 3 mg/ L). With 10 years of follow-up, 547 participants developed coronary heart disease (CHD; defined as myocardial infarction or coronary death). With elevated CRP, the 10-year cumulative CHD incidences were 33% in men and 17% in women. The age-, ethnicity-, and sex-adjusted relative risk of CHD for CRP > 3 mg/ L compared with < 1 mg/ L was 1.82 (95% CI, 1.46 to 2.28). Adjusting for conventional risk factors reduced the relative risk to 1.45 ( 95% CI, 1.14 to 1.86). The population-attributable risk of CHD for elevated CRP was 11%. Risk relationships did not differ in subgroups defined by baseline risk factors. We assessed whether CRP improved prediction by the Framingham Risk Score. Among men with a 10-year Framingham-predicted risk of 10% to 20%, the observed CHD incidence was 32% for elevated CRP. Among women, CRP discriminated best among those with a 10-year predicted risk > 20%; the incidences were 31% and 10% for elevated and normal CRP levels, respectively.Conclusions - In older men and women, elevated CRP was associated with increased 10-year risk of CHD, regardless of the presence or absence of cardiac risk factors. A single CRP measurement provided information beyond conventional risk assessment, especially in intermediate-Framingham-risk men and high-Framingham-risk women.