Serum amyloid P and cardiovascular disease in older men and women: results from the Cardiovascular Health Study.
OBJECTIVE
Serum amyloid P (SAP), a pentraxin like C-reactive protein (CRP), functions in innate immunity. However, associations of SAP with cardiovascular disease (CVD) are unknown.


RESULTS
We examined these associations in the Cardiovascular Health Study using a case-cohort design. Nonexclusive case groups were incident angina (n=523), myocardial infarction (MI; n=308), stroke (n=323), and CVD death (n=288). 786 participants had no events. SAP was correlated with CRP, CVD risk factors (obesity, blood pressure, lipids), common and internal carotid wall thickness, and ankle-brachial index (all P<0.02). In Cox regression models adjusted for age, sex, and ethnicity, a standard deviation increase in SAP (9.8 mg/L) was associated with angina (hazard ratio; 95% confidence interval 1.3; 1.2 to 1.5) and MI (1.3; 1.1 to 1.5), but not stroke (1.1; 0.9 to 1.3) or CVD death (1.1; 0.9 to 1.3). Adding CRP to the models had no significant effect on associations. Adjusting for CVD risk factors slightly attenuated SAP associations with CVD events; however, associations with angina and MI remained significant.


CONCLUSIONS
Although both are pentraxins, SAP and CRP may represent different facets of inflammation. The association of SAP with CVD in these older adults further supports the role of innate immunity in atherosclerosis.
Jenny
Nancy Swords
NS
Department of Pathology, College of Medicine, University of Vermont, 208 South Park Drive, Suite 2, Colchester, VT 05446, USA. Nancy.Jenny@uvm.edu
Arnold
Alice M
AM
Kuller
Lewis H
LH
Tracy
Russell P
RP
Psaty
Bruce M
BM
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D000789:Angina, Unstable / Q000209:etiology / Q000378:metabolism; D050197:Atherosclerosis / Q000276:immunology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000235:genetics / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism; D007113:Immunity, Innate; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000378:metabolism; D009765:Obesity / Q000378:metabolism; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D000683:Serum Amyloid P-Component / Q000235:genetics / Q000378:metabolism*
D000683:Serum Amyloid P-Component; D002097:C-Reactive Protein