C-reactive protein is related to extent and progression of coronary and extra-coronary atherosclerosis; results from the Rotterdam study.
OBJECTIVE
Although prospective studies have unequivocally shown that C-reactive protein (CRP) is an independent predictor of future cardiovascular events, studies on the association between CRP and atherosclerosis have provided inconsistent results. We investigated the association of CRP with extent and progression of atherosclerosis in multiple vessel beds in a large, population-based cohort study.


METHODS
In the Rotterdam Study, standardized measurements of coronary and extra-coronary atherosclerosis were performed in 1962 persons and 6582 persons, respectively. Progression of extra-coronary atherosclerosis during a mean follow-up period of 6.4 years was assessed in 3757 persons.


RESULTS
Independent and graded associations were found of CRP with the number of carotid plaques and carotid plaque progression ((OR 1.72; 95% CI 1.14-2.59) for severe progression in participants with CRP>3mg/dl versus participants with CRP<1mg/dl). Similarly, CRP was independently and graded related to ankle-brachial-index (ABI) and worsening ABI over the years ((OR 1.99; 95% CI 1.37-2.88) for severe progression in participants with CRP>3mg/dl versus participants with CRP<1mg/dl). Although CRP was independently related to the highest level of carotid intima-media thickness (IMT), the association with change in IMT was not significant. Furthermore, there was an independent, graded relation between CRP and aortic calcification, but no independent association was observed with progression of aortic calcification, nor with the amount of coronary calcification.


CONCLUSIONS
In this population-based study, independent and graded associations were present of CRP with extent and progression of carotid plaques and ABI, while associations with carotid IMT and aortic and coronary calcification were less pronounced.
Elias-Smale
Suzette E
SE
Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Kardys
Isabella
I
Oudkerk
Matthijs
M
Hofman
Albert
A
Witteman
Jacqueline C M
JC
D000368:Aged; D000704:Analysis of Variance; D001011:Aorta / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D050197:Atherosclerosis / Q000097:blood / Q000276:immunology*; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis / Q000276:immunology*; D002114:Calcinosis; D002340:Carotid Artery Diseases / Q000276:immunology / Q000473:pathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D014463:Ultrasonography
D015415:Biomarkers; D002097:C-Reactive Protein