C-reactive protein is not associated with the presence or extent of calcified subclinical atherosclerosis.
BACKGROUND
Both high-sensitivity C-reactive protein (hsCRP) and electron beam computed tomography (EBCT) coronary artery calcification (CAC) are valid markers of cardiovascular risk. It is unknown whether hsCRP is a marker of atherosclerotic burden or whether it reflects a process (eg, inflammatory fibrous cap degradation) leading to acute coronary events.


METHODS
A nested case-control study was performed of 188 men enrolled in the Prospective Army Coronary Calcium study. The serum hsCRP levels (latex agglutination assay) were evaluated in subjects with CAC (CAC score >0, n = 94) and compared with age- and smoking status-matched control subjects (CAC score 0, n = 94).


RESULTS
Levels of hsCRP in the highest quartile were related to the following coronary risk factors: smoking status, low-density lipoprotein cholesterol, body mass index, glycosylated hemoglobin, fibrinogen, and homocysteine. The mean hsCRP level was similar in cases (+CAC, 0.20 +/- 0.22 mg/dL) and controls (-CAC, 0.19 +/- 0.21 mg/dL; P =.81) and was unrelated to the log-transformed CAC score (r < 0.01, P =.91). Multivariable analysis controlling for standard risk factors, aspirin, and statin therapy found only that low-density lipoprotein cholesterol was related to CAC.


CONCLUSIONS
Despite associations with standard and emerging cardiovascular risk factors, hsCRP is unrelated to the presence and extent of calcified subclinical atherosclerosis. This implies that CAC (a disease marker) and hsCRP (a process marker) may be complementary for the prediction of cardiovascular risk.
Hunt
M E
ME
Department of Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
O'Malley
P G
PG
Vernalis
M N
MN
Feuerstein
I M
IM
Taylor
A J
AJ
D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D002097:C-Reactive Protein; D008078:Cholesterol, LDL; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D006710:Homocysteine