title: Basal high-sensitivity-C-reactive protein levels in patients with spontaneous venous thromboembolism.
abstract: The role of C-reactive protein (CRP) in venous thromboembolism (VTE) is still under discussion because of controversial results in the literature. Conflicting data may have partly been due to bias by exogenous factors altering CRP levels. We investigated CRP concentrations in patients with spontaneous VTE applying a study design that allowed the measurement of basal high sensitivity (hs)-CRP levels. Patients with a history of deep vein thrombosis (DVT, n=117) and pulmonary embolism (PE, n=97) were compared to healthy individuals (n=104). Hs-CRP levels (mg/dl) were significantly higher in patients (n=214, median/interquartile range: 0.171/0.082-0.366) than in controls (0.099/0.053-0.245, p=0.001). The unadjusted odds ratio (OR) for VTE per 1 mg/dl increase of CRP was 2.8 [95% confidence interval (CI): 1.1-6.8, p=0.03]. This association remained significant after adjustment for factor V Leiden, prothrombin G20210A and factor VIII activity above 230% (OR = 2.9, 95% CI [1.1-7.5]), but became remarkably attenuated and lost its statistical significance after adjustment for BMI alone (OR = 1.7 [0.7-4.0]). CRP was also not independently associated with VTE in subgroups of patients (those with DVT without symptomatic PE, those with PE and patients without established risk factor) in multiple regression analysis. In summary, we observed significantly higher basal hs-CRP levels in patients with spontaneous VTE compared to healthy controls. This association was independent of hereditary and laboratory risk factors for VTE, but lost its significance after adjustment for BMI. Increased basal CRP levels do not appear to represent an independent risk factor for VTE.
authors.affiliation: Department of Internal Medicine I, Division of Haematology and Haemostaseology, University Hospital Vienna, Vienna, Austria.
authors.forename: Rainer
authors.initials: R
authors.lastname: Vormittag
authors.forename: Thomas
authors.initials: T
authors.lastname: Vukovich
authors.forename: Verena
authors.initials: V
authors.lastname: Schönauer
authors.forename: Stephan
authors.initials: S
authors.lastname: Lehr
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.forename: Christine
authors.initials: C
authors.lastname: Bialonczyk
authors.forename: Mirko
authors.initials: M
authors.lastname: Hirschl
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002352:Carrier Proteins / Q000097:blood* / Q000502:physiology; D016022:Case-Control Studies; D005165:Factor V; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011516:Prothrombin / Q000235:genetics; D011655:Pulmonary Embolism / Q000097:blood / Q000209:etiology; D012044:Regression Analysis; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood* / Q000209:etiology
chemical_list: D002352:Carrier Proteins; C020723:citrate-binding transport protein; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin; D005169:Factor VIII