Comparison of characteristics of future myocardial infarctions in women with baseline high versus baseline low levels of high-sensitivity C-reactive protein.
High-sensitivity C-reactive protein (hs-CRP) has previously been shown to be an independent predictor for the development of cardiovascular disease. However, little is known about the association between hs-CRP and the severity of cardiovascular events that occur. This study compared characteristics of incident myocardial infarctions (MIs) in 40 initially healthy women with very high baseline hs-CRP levels (>7.5 mg/L) with infarctions in 40 women with very low hs-CRP levels (< or =1 mg/L). At baseline, very high hs-CRP was associated with a clinical diagnosis of hypertension, higher body mass index, lower high-density lipoprotein, and higher triglycerides. Our analysis found that the 2 study groups had similar proportions of ST-segment elevations on electrocardiograms, peak cardiac enzyme levels, postinfarct left ventricular function, and burden of coronary atherosclerosis seen on angiography. However, subjects with very high hs-CRP levels developed infarctions significantly sooner than those with very low hs-CRP levels (median time to event 4.45 vs 6.64 years, respectively, p <0.0001). In addition, higher baseline levels of hs-CRP were associated with significantly more fatal MIs (0% vs 4.6% vs 9.6% in subjects with hs-CRP levels <1, 1 to <3, and > or =3 mg/L, respectively, p for trend = 0.02). In conclusion, this study demonstrates that in initially healthy women high levels of hs-CRP predict earlier occurrence of MIs and a greater likelihood that infarctions will be fatal.
Bansal
Sandeep
S
Center for Cardiovascular Disease Prevention, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. sbansal@partners.org
Ridker
Paul M
PM
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000097:blood; D023921:Coronary Stenosis / Q000097:blood / Q000150:complications / Q000453:epidemiology; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014280:Triglycerides / Q000097:blood; D014336:Troponin / Q000097:blood
D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides; D014336:Troponin; D002097:C-Reactive Protein; D003402:Creatine Kinase