title: C-reactive protein predicts carotid atherosclerosis progression in mild to moderate risk and middle-aged patients.
abstract: OBJECTIVE
  The Framingham risk score is a popular tool for estimating cardiovascular risk, but there is debate about the value of C-reactive protein. This study investigated the utility of C-reactive protein to predict the progression of atherosclerosis in relation to the Framingham risk score and age.
  
  
  METHODS
  This observational study enrolled 164 outpatients (mean age: 61 yr; range: 40 - 75 yr) receiving treatment for classical cardiovascular risk factors. They underwent serial ultrasonographic evaluation of their carotid arteries for 36 +/- 10 months. A carotid intima-media thickness > or = 1.1 mm was defined as plaque, and the number of plaques and plaque score (sum of all plaque thicknesses) were determined. Serum C-reactive protein concentrations and classical risk factors, including body mass index, were measured.
  
  
  RESULTS
  C-reactive protein was related to annual changes in the number of plaques and the plaque score (r=0.26 and 0.28; P<0.01 and P<0.001, respectively), as well as the 10-year risk of cardiovascular disease estimated from the Framingham risk score (r=0.335, P<0.001). C-reactive protein was correlated with the annual changes of plaque number and plaque score (beta=0.21 and 0.23; P<0.05 and P<0.01) after adjusting for 10-year cardiovascular and other risk factors, especially in 64 patients comprising the 8-13% 10-year risk group (beta=0.33 for plaque score, P<0.05). CRP also showed a relationship with the progression of carotid atherosclerosis in 71 patients aged < or = 61 yr (beta=0.33 for plaque score, P<0.01).
  
  
  CONCLUSIONS
  C-reactive protein can predict the progression of early carotid atherosclerosis in patients with mild to moderate cardiovascular risk and/or middle-aged patients.
authors.affiliation: Department of Internal Medicine, Osaka National Hospital 2-1-14, Hoenzaka, Chuo-ku, Osaka, Japan. hashih@onh.go.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Hougaku
authors.forename: Hideki
authors.initials: H
authors.lastname: Etani
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D002340:Carotid Artery Diseases / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein