Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study
Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study
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DOI：
10.1093/oxfordjournals.aje.a008963
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发表时间：
1996-09-15
影响因子：
5
通讯作者：
Meilahn, EN
中科院分区：
文献类型：
--
作者：
Kuller, LH;Tracy, RP;Meilahn, EN
作者在多重危险因素干预试验（MRFIT）参与者中进行了一项巢式病例对照研究，测量了C - 反应蛋白、α(1)酸性糖蛋白和一种急性期蛋白白蛋白与随后心肌梗死和冠心病死亡风险之间的关系。其中有98例心肌梗死病例、148例冠心病死亡病例和491例对照。对病例和对照进行了长达17年的死亡随访以及6 - 7年的心肌梗死病例和对照随访。C - 反应蛋白的现有分布与随后的冠心病死亡率之间存在显著关联。对于基线时的吸烟者，C - 反应蛋白处于第4四分位数者与处于第1四分位数者相比，冠心病死亡风险为4.3（95%置信区间为1.74 - 10.8）。在对试验期间与吸烟和戒烟相关的特征以及肺功能进行调整后，这种关联仍然存在。α(1)酸性糖蛋白与心肌梗死或冠心病死亡均无关。白蛋白仅与基线后7 - 13年发生的冠心病死亡呈负相关，这与之前的MRFIT分析结果一致。这是第一项在“健康但高危个体”中记录C - 反应蛋白与冠心病死亡率之间关系的前瞻性研究。
The authors measured the relation between C-reactive protein, alpha(1) acid glycoprotein and albumin, an acute phase protein, and subsequent risk of myocardial infarction and coronary heart disease death in a nested case-control study among the Multiple Risk Factor Intervention Trial (MRFIT) participants. There were 98 myocardial infarction cases, 148 coronary heart disease deaths, and 491 controls. The cases and controls were followed for up to 17 years for deaths and 6-7 years for myocardial infarction cases and controls. There was a significant association between available distribution of C-reactive protein and subsequent coronary heart disease mortality. For smokers at baseline, the risk of coronary heart disease deaths in quartile 4 of C-reactive protein as compared with quartile 1 was 4.3 (95% confidence interval 1.74-10.8). The association persisted when adjusted for characteristics related to smoking and smoking cessation during the trial and to pulmonary function. There was no relation between alpha(1) acid glycoprotein and either myocardial infarction or coronary heart disease death. Albumin was inversely related to coronary heart disease death only for deaths that occurred between 7 and 13 years after baseline, consistent with previous MRFIT analyses. This is the first prospective study in ''healthy but high risk individuals'' to document the relation between C-reactive protein and coronary heart disease mortality.