title: C-reactive protein as a marker of cardiovascular disease in patients with a schizophrenia spectrum disorder treated in routine medical practice.
abstract: OBJECTIVE
  Interest in cardiovascular diseases (CVD) in schizophrenia has grown recently due to documented incremental mortality. C-reactive protein (CRP) has been assessed as a marker in individuals with CVD and/or at high risk of developing it. However, its role in schizophrenia patients is unknown. The goal of this research was thus to explore the use of CRP as a marker of CVD risk in patients with schizophrenia.
  
  
  METHODS
  A cross-sectional analysis of the Badalona Serveis Assistencials (BSA) administrative claims database was conducted including all subjects aged>18 years with a diagnosis of schizophrenia spectrum disorder. CRP measurement, sociodemographics, medical history, 10-year CVD risk (Framingham function) and clinical chemistry data were extracted for analysis.
  
  
  RESULTS
  Seven hundred and five patients (53.0% men, 48.2 [15.8] years, 78.7% on atypicals) met criteria for analysis. Mean 10-year CVD risk was high; 11.9±5.7% and mean CRP levels were 2.6±2.5 mg/L with 30.4% showing above-normative levels (>3 mg/L). After adjusting for age, gender, smoking and presence of neoplasm or inflammatory diseases, CRP was linearly associated with 10-year CVD risk stratified by risk (low, moderate, high/very high): respectively, 2.3 (95% CI: 2.1-2.5), 3.1 (2.6-3.5) and 3.7 (3.2-4.1) mg/L; F=13.5, P<0.001. Patients with known CVD also showed higher CRP levels: 3.7 (2.9-4.5) vs. 2.5 (2.4-2.7) mg/L, P=0.008; and higher probability of above-normal values; odds ratio=4.71 (2.01-11.04), P<0.001.
  
  
  CONCLUSIONS
  High CRP levels above normative were associated with both known CVD and high/very high 10-year risk of a CVD event in patients with schizophrenia, suggesting CRP could be a marker of CVD in this psychiatric disorder.
authors.affiliation: Directorate of Planning, Department of Psychiatry, Badalona Serveis Assistencials, Badalona, Barcelona, Spain. asicras@bsa.cat
authors.forename: A
authors.initials: A
authors.lastname: Sicras-Mainar
authors.forename: J
authors.initials: J
authors.lastname: Rejas-Gutiérrez
authors.forename: R
authors.initials: R
authors.lastname: Navarro-Artieda
authors.forename: M
authors.initials: M
authors.lastname: Blanca-Tamayo
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012559:Schizophrenia / Q000097:blood / Q000150:complications*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein