title: Serum amyloid P and cardiovascular disease in older men and women: results from the Cardiovascular Health Study.
abstract: 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.
authors.affiliation: Department of Pathology, College of Medicine, University of Vermont, 208 South Park Drive, Suite 2, Colchester, VT 05446, USA. Nancy.Jenny@uvm.edu
authors.forename: Nancy Swords
authors.initials: NS
authors.lastname: Jenny
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
mesh_terms: 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*
chemical_list: D000683:Serum Amyloid P-Component; D002097:C-Reactive Protein