title: Association of C-reactive protein and homocysteine with subclinical coronary plaque subtype and stenosis using low-dose MDCT coronary angiography.
abstract: OBJECTIVE
  Given the uncertainty regarding the relationship of C-reactive protein (CRP) and homocysteine (Hcy) to atherosclerotic burden, our aim was to determine whether CRP and Hcy are related to the presence of subclinical coronary plaque and stenosis.
  
  
  METHODS
  We did a cross-sectional analysis of data gathered on 1248 consecutive, newly self-referred, middle-aged subjects who underwent health check ups at China Medical University Hospital. Participants had at least one cardiac risk factor, but no known coronary heart disease. Low-dose multidetector computed tomography coronary angiography (MDCT-CA) was used to measure coronary artery stenosis and identify plaque subtypes.
  
  
  RESULTS
  Subjects were divided into quartiles based on levels of high-sensitivity (hs)-CRP and Hcy. hs-CRP level and Hcy level were associated with the relative proportion of plaque subtypes; Hcy level (P<0.05) but not hs-CRP level (P>0.05) was associated with prevalence of artery segment stenosis. After multivariate adjustment for traditional cardiovascular risk factors through logistic regression analysis, neither hs-CRP level nor Hcy level was independently associated with coronary plaque subtypes and stenosis (P>0.05).
  
  
  CONCLUSIONS
  Subclinical atherosclerosis is mildly increased in subjects with higher CRP and Hcy levels, but this association is not independent of traditional cardiovascular risk factors. CRP and Hcy are poor predictors of atherosclerotic burden and coronary stenosis.
authors.affiliation: Department of Medicine, College of Medicine, China Medical University, Preventive Medicine Center, China Medical University Hospital, Taiwan. tsann_lin@yahoo.com.tw
authors.forename: Tsann
authors.initials: T
authors.lastname: Lin
authors.forename: Juhn-Cherng
authors.initials: JC
authors.lastname: Liu
authors.forename: Li-Ya
authors.initials: LY
authors.lastname: Chang
authors.forename: Chien-Wei
authors.initials: CW
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000096:biosynthesis*; D003251:Constriction, Pathologic / Q000378:metabolism*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood* / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012306:Risk; D012307:Risk Factors
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein