Elevated serum C-reactive protein levels predict cardiovascular events in the Japanese coronary artery disease (JCAD) study.
BACKGROUND
Accumulating evidence indicates that C-reactive protein (CRP) is an independent predictive factor for atherosclerotic vascular disease in Caucasians. Accordingly, this study sought to investigate the relationship between the serum level of CRP and cardiovascular events of Japanese patients with coronary artery disease (CAD).


RESULTS
The Japanese CAD (JCAD) study enrolled 15,628 patients who had significant diameter stenosis (>or=75%) in at least 1 coronary artery. Of these, 6,802 patients had their baseline serum CRP data available. Patients were followed up for a mean of 2.7 years (follow-up rate 88.3%). The primary endpoint of the JCAD study was all events. Baseline covariates possibly influencing the event rate were adjusted between the 2 groups with and without elevated serum CRP level. Kaplan-Meier analysis demonstrated a 30% higher all-events rate in patients with a serum level of CRP >or=0.1 mg/dl (P=0.0002). Cox proportional hazard analysis also showed that a serum level of CRP >or=0.1 mg/dl was an independent predictor of all events (P=0.0001), and of cardiac events and cardiac death (P=0.0005).


CONCLUSIONS
Elevated serum level of CRP is an independent predictor of cardiovascular events in JCAD patients.
Shimada
Kenei
K
Department of Cardiology, Osaka Ekisaikai Hospital, Osaka, Japan.
Fujita
Masatoshi
M
Tanaka
Atsushi
A
Yoshida
Ken
K
Jisso
Satoshi
S
Tanaka
Hidemasa
H
Yoshikawa
Junichi
J
Kohro
Takahide
T
Hayashi
Doubun
D
Okada
Yoshihiro
Y
Yamazaki
Tsutomu
T
Nagai
Ryozo
R
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors
D002097:C-Reactive Protein