Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: The cardiovascular health study
Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: The cardiovascular health study
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DOI：
10.1016/j.jacc.2007.07.064
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发表时间：
2007-11-13
影响因子：
24
通讯作者：
Griffin, Brian P.
中科院分区：
文献类型：
--
作者：
Novaro, Gian M.;Katz, Ronit;Griffin, Brian P.
Objectives本研究的目的是在一个大的、随机选择的、以人群为基础的队列中研究C-反应蛋白（CRP）和钙化性主动脉瓣疾病之间的关系。背景钙化性主动脉瓣狭窄的病理学涉及一个活跃的炎症、动脉粥样硬化、成骨过程。CRP的升高，全身炎症的措施，已与主动脉stenosis.Methods二维和多普勒超声心动图和CRP测量进行了基线在心血管健康研究的5,621名参与者。多变量分析被用来确定CRP作为基线和事件的预测主动脉stenosis.Results在平均超声心动图随访5年，9%的主动脉硬化症患者进展到一定程度的主动脉瓣狭窄。年龄增长（比值比[OR] 1.13，95%置信区间[CI] 1.09至1.16; p < 0.001）和男性（OR 3.05，95%CI 1.76至5.27; p < 0.001）与主动脉瓣狭窄的风险相关，而身高增加（OR 0.96，95% CI 0.94至0.99; p = 0.013）和非裔美国人种族传达了较低的风险（OR 0.49，95% CI 0.25至0.95; p = 0.035）。C-反应蛋白作为一个连续变量，与基线主动脉瓣狭窄、进展为主动脉硬化（调整OR 0.93，95% CI 0.85 - 1.02; p = 0.107），或进展为主动脉瓣狭窄（调整OR 0.85，95%CI 0.70 ~ 1.03; p = 0.092）结论在这个大规模人群队列中，约9%的主动脉硬化患者在5年随访期内进展为主动脉瓣狭窄。CRP水平与钙化性主动脉瓣疾病或主动脉瓣狭窄之间没有相关性。C反应蛋白似乎是亚临床钙化性二尖瓣疾病的不良预测因子。（J Am科尔心脏病学杂志2007;50：1992-9）（c）美国心脏病学会基金会2007年。
Objectives The purpose of this study was to examine the relationship between C-reactive protein (CRP) and calcific aortic valve disease in a large, randomly selected, population-based cohort.Background The pathobiology of calcific aortic stenosis involves an active inflammatory, atheromatous, osteogenic process. Elevations in CRP, a measure of systemic inflammation, have been associated with aortic stenosis.Methods Two-dimensional and Doppler echocardiography and CRP measurement were performed at baseline in 5,621 participants in the Cardiovascular Health Study. Multivariable analysis was used to identify CRP as a predictor of baseline and incident aortic stenosis.Results At a mean echocardiographic follow-up of 5 years, 9% of subjects with aortic sclerosis progressed to some degree of aortic stenosis. Increasing age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.16; p < 0.001) and male gender (OR 3.05, 95% Cl 1.76 to 5.27; p < 0.001) were related to risk of incident aortic stenosis, whereas increasing height (OR 0.96, 95% Cl 0.94 to 0.99; p = 0.013) and African-American ethnicity conveyed a lower risk (OR 0.49, 95% Cl 0.25 to 0.95; p = 0.035). C-reactive protein, treated as a continuous variable, was not associated with baseline aortic stenosis, progression to aortic sclerosis (adjusted OR 0.93, 95% Cl 0.85 to 1.02; p = 0.107), or progression to aortic stenosis (adjusted OR 0.85, 95% Cl 0.70 to 1.03; p = 0.092).Conclusions In this large population-based cohort, approximately 9% of subjects with aortic sclerosis progressed to aortic stenosis over a 5-year follow-up period. There was no association between CRP levels and the presence of calcific aortic-valve disease or incident aortic stenosis. C-reactive protein appears to be a poor predictor of subclinical calcific aortic-valve disease. (J Am Coll Cardiol 2007;50:1992-9) (c) 2007 by the American College of Cardiology Foundation.