title: Carotid intima-media thickness, systemic inflammation, and incidence of heart failure hospitalizations.
abstract: OBJECTIVE
  This study explored the relationships between carotid intima-media thickness (IMT), plasma levels of C-reactive protein (CRP), and incidence of heart failure hospitalizations.
  
  
  RESULTS
  Men and women from the general population (n=4691), without history of myocardial infarction or stroke, were examined. Incidence of hospitalizations attributable to heart failure was studied over a mean follow-up of 13 years. A total of 75 subjects were hospitalized with a primary diagnosis of heart failure. Adjusted for risk factors, the hazards ratios (95% CI) were 1.00, 0.98 (0.36 to 2.7), 1.9 (0.80 to 4.6), and 2.7 (1.1 to 6.2), respectively, for the 1st, 2nd, 3rd, and 4th quartiles of IMT (P for trend=0.003). The HR associated with CRP levels >or=3 mg/L (versus <1 mg/L) was 2.0 (95% CI: 1.06 to 3.9) after adjustments for risk factors. There was a significant interaction between IMT and CRP on heart failure incidence (P=0.028). Subjects with CRP >or=3 mg/L and IMT in the 4th quartile had an adjusted HR of 3.7 (1.9 to 7.1) compared to those with CRP <3 mg/L and IMT in quartile 1 to 3.
  
  
  CONCLUSIONS
  High IMT and high CRP are both independent risk factors for incidence of heart failure requiring hospitalization. The joint exposure to both risk factors substantially increases the risk.
authors: Department of Clinical Sciences in Malmö, Lund University, Malmö University Hospital, Sweden. Gunnar.Engstrom@med.lu.se
authors: Gunnar
authors: G
authors: Engström
authors: Olle
authors: O
authors: Melander
authors: Bo
authors: B
authors: Hedblad
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis*; D002339:Carotid Arteries / Q000473:pathology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*
chemical_list: D002097:C-Reactive Protein