C-reactive protein predicts progression of atherosclerosis measured at various sites in the arterial tree: the Rotterdam Study.
Background and Purpose- C-reactive protein (CRP) predicts myocardial infarction and stroke. Its role as a predictor of the progression of subclinical atherosclerosis is not yet known. We investigated whether CRP predicts progression of atherosclerosis measured at various sites in the arterial tree.


METHODS
CRP levels were measured in a random sample of 773 subjects >/=55 years of age who were participating in the Rotterdam Study. Subclinical atherosclerosis was assessed at various sites at 2 points in time, with a mean duration between measurements of 6.5 years.


RESULTS
After adjustment for age, sex, and smoking habits, odds ratios (ORs) associated with CRP levels in the highest compared with the lowest quartile were increased for progression of carotid (OR, 1.9; 95% CI, 1.1 to 3.3), aortic (OR, 1.7; 95% CI, 1.0 to 3.0), iliac (OR, 2.0; 95% CI, 1.2 to 3.3), and lower extremity (OR, 1.9; 95% CI, 1.0 to 3.7) atherosclerosis. The OR for generalized progression of atherosclerosis as indicated by a composite progression score was 4.5 (95% CI, 2.3 to 8.5). Except for aortic atherosclerosis, these estimates hardly changed after additional adjustment for multiple cardiovascular risk factors. In addition, ORs for progression of atherosclerosis associated with high CRP levels were as high as those associated with the traditional cardiovascular risk factors high cholesterol, hypertension, and smoking. Geometric mean levels of CRP increased with the total number of sites showing progression of atherosclerosis (P=0.002 for trend).


CONCLUSIONS
CRP predicts progression of atherosclerosis measured at various sites in the arterial tree.
Van Der Meer
Irene M
IM
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
De Maat
Moniek P M
MP
Hak
A Elisabeth
AE
Kiliaan
Amanda J
AJ
Del Sol
Antonio Iglesias
AI
Van Der Kuip
Deirdre A M
DA
Nijhuis
Rogier L G
RL
Hofman
Albert
A
Witteman
Jacqueline C M
JC
D017677:Age Distribution; D000368:Aged; D000842:Ankle; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001132:Arm; D001161:Arteriosclerosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis*; D002114:Calcinosis / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014463:Ultrasonography
D002097:C-Reactive Protein