C-reactive protein, fibrin D-dimer, and risk of ischemic heart disease: the Caerphilly and Speedwell studies.
BACKGROUND
There is increasing interest in the predictive value of C-reactive protein (CRP) and fibrin D-dimer in the prediction of ischemic heart disease (IHD). We assessed their joint and independent associations with IHD in a large combined analysis of 2 population cohorts.


RESULTS
Men aged 49 to 66 years from the general populations of Caerphilly and Speedwell were studied between 1982 and 1988 and re-examined for new IHD events at fixed intervals of approximately 105 months (Caerphilly) and 75 months (Speedwell). 3213 men had CRP and D-dimer measured at baseline and 351 (11%) had a new IHD event. Mean levels of CRP and D-dimer were significantly higher among men in whom IHD developed. The relative odds of IHD in men in the top 20% of the distribution of CRP was 2.97 (95% CI, 2.04, 4.32) and for D-dimer was 2.40 (95% CI, 1.69, 3.40); CRP and D-dimer had additive effects on risk of IHD. Multivariate analysis reduced the size of the relative odds, which remained significant for D-dimer.


CONCLUSIONS
Both inflammatory and thrombogenic markers are important (and potentially additive) predictors of coronary risk.
Department of Medicine, University of Glasgow, Scotland, UK. gdl1j@clinmed.gla.ac.uk
G D O
GD
Lowe
P M
PM
Sweetnam
J W G
JW
Yarnell
A
A
Rumley
C
C
Rumley
D
D
Bainton
Y
Y
Ben-Shlomo
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001780:Blood Coagulation Tests; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D015331:Cohort Studies; D005215:Fasting / Q000097:blood; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005340:Fibrinogen / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000097:blood / Q000453:epidemiology*; D016017:Odds Ratio; D011237:Predictive Value of Tests
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005340:Fibrinogen; D002097:C-Reactive Protein