title: C-reactive protein predicts death in patients with previous premature myocardial infarction--a 10 year follow-up study.
abstract: Atherosclerosis is an inflammatory disease. C-reactive protein (CRP), a marker of inflammation, is associated with coronary heart disease (CHD). We measured CRP in a cohort of 247 patients (193 males and 54 females) who had had their first myocardial infarction (MI) at age < or = 55 (males) or < or = 60 (females). The cut-off values of the 25th, 50th and 75th centiles of CRP were 1.20, 2.37 and 4.20 mg/l. After 10 years, a total of 44 patients (17.8%) had died, 36 (81.8%) of cardiac causes. Unadjusted and adjusted (i.e. for age, ejection fraction (EF), serum total cholesterol (TC), fibrinogen, smoking and hypertension) relative risks (RRs) for total and cardiac mortality were generated. CRP was a strong predictor of death of all causes due to its strength as predictor of cardiac death. The RR of cardiac death was doubled with increasing CRP quartiles, and patients in the top quartile had six times as high risk of cardiac death as patients in the lowest quartile. The RRs were moderately attenuated after adjustment, but still significant. We conclude that CRP is a strong predictor of mortality in patients with premature MI. Thus, inflammation appears to be a critical prognostic factor in patients with previous premature MI.
authors.affiliation: Institute of Medical Genetics, University of Oslo, PO Box 1036 Blindern, 0315 Oslo, Norway. l.j.retterstol@ioks.uio.no
authors.forename: Lars
authors.initials: L
authors.lastname: Retterstol
authors.forename: Lars
authors.initials: L
authors.lastname: Eikvar
authors.forename: Morten
authors.initials: M
authors.lastname: Bohn
authors.forename: Anette
authors.initials: A
authors.lastname: Bakken
authors.forename: Jan
authors.initials: J
authors.lastname: Erikssen
authors.forename: Kare
authors.initials: K
authors.lastname: Berg
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013318:Stroke Volume; D015996:Survival Rate
chemical_list: D008055:Lipids; D005340:Fibrinogen; D002097:C-Reactive Protein