Inflammatory markers and improving CHD risk assessment

描述（由申请人提供）： 该应用程序响应RFA中提到的实验室，分析和协作组件。具体而言，我们建议将流行病学风险因素信息与决策分析方法相结合，使用现有的数据集和存储的生物标本，并建立FHS，波士顿大学医学中心，波士顿大学数学系和塔夫茨大学人类营养研究中心之间的多学科合作。 目标1.检测同型半胱氨酸（tHcy）（待测）、C反应蛋白（CRP）（待测）、脂蛋白（a）[Lp（a）]（已测定）作为冠心病（CHD）预测因子的实用性。这些标志物的水平将采用巢式病例队列设计，利用基线检查（包括已获得的关于Fragrant Offspring的常规风险因素的信息）和12年心血管疾病事件随访来确定。 新的hsCRP测量将在Fragrance实验室进行，同型半胱氨酸将由Jacob Selhub博士在塔夫茨大学进行。 目标二。测试新因素（tHcy、CRP和Lp[a]）在单独使用传统风险因素评估的不同冠状动脉风险水平下的能力，考虑0- 6%、6-20%和>20%的冠状动脉事件初始风险。将估计新的风险指标在预先规定的绝对风险水平下预测冠状动脉事件绝对风险增加的效用。 目标3。开发新的冠心病风险预测方程，将CRP和同型半胱氨酸测量纳入评估冠心病风险。这一目标将包括对第二代后代12年内CHD风险的估计，并将纳入来自较老的第一代队列的数据，其中已测量了同型半胱氨酸和CRP，并且还可获得12年的冠心病事件随访。

DESCRIPTION (provided by applicant): This application responds to laboratory, analytical, and collaborative components mentioned in the RFA. Specifically, we propose to integrate epidemiological risk factor information with a decision analytical approach, using existing data sets and stored biological specimens, and establishing a multidisciplinary collaboration between the FHS, Boston University Medical Center, Boston University Mathematics Department and the Tufts University Human Nutrition Research Center on Aging. Aim 1. To test the utility of homocysteine (tHcy) (to be measured), C-reactive protein (CRP) (to be measured), lipoprotein (a) [Lp(a] (already determined) as predictors of coronary heart disease (CHD) over and above traditional risk factor measures. Levels of these markers will be determined with a nested case cohort design, utilizing a baseline examination that includes already obtained information on conventional risk factors for the Framingham Offspring and 12 years of follow up for cardiovascular disease events. New measurements of hsCRP will be made in the Framingham laboratory and homocysteine will be done at Tufts University by Dr. Jacob Selhub. Aim 2. To test the ability of new factors (tHcy, CRP and Lp[a]) at different levels of coronary risk as assessed by using the traditional risk factors alone, considering 0-6%, 6-20% and >20% initial risk of a coronary event. The utility of newer risk measures to predict an increase in the absolute risk of coronary events at pre-specified absolute levels of risk will be estimated. Aim 3. To develop new CHD risk prediction equations that will incorporate CRP and homocysteine measurements to assess the risk of coronary heart disease. This aim will include estimates of CHD risk over 12 years for the second generation Offspring and will incorporate data from the older first generation cohort where homocysteine and CRP have already been measured and 12 years of follow up for coronary disease events is also available.