title: HDL-C levels modify the association between C-reactive protein and coronary artery calcium score.
abstract: OBJECTIVE
  C-reactive protein (CRP) levels predict incident and recurrent cardiovascular disease (CVD) events; however, associations between CRP and pre-clinical atherosclerosis is less certain. Since high concentrations of high-density lipoprotein cholesterol (HDL-C) are inversely associated with CVD risk, we investigated whether HDL-C modified the association between CRP concentration and measures of preclinical atherosclerosis.
  
  
  RESULTS
  Data were analyzed from a Korean occupational cohort of 12,030 male subjects who underwent a cardiac computed tomography (CT) estimation of coronary artery calcification (CAC) score and an assessment of CVD risk factors. Logistic regression was used to describe associations between CRP and measures of pre-clinical atherosclerosis, such as CAC scores >0. As many as 1351 (11.2%) participants had a CAC score>0. CRP was stratified into 3 groups based on clinical category: <1 mg/L, 1 to <2 mg/L, and ≥ 2 mg/dL. In the bottom CRP group, 907/8697 (10.4%) of subjects had a CAC score >0, compared with 242/1943 (12.5%) in the middle group and 202/1396 (14.5%) in the top CRP group (p < 0.0001). After adjustment for multiple CVD risk factors, there was a positive association between CRP and CAC score>0 (OR between top and bottom CRP groups, 1.41 [1.04, 1.90], p = 0.027) in the lowest HDL-C quartile but not in the highest HDL-C (OR between top and bottom CRP group, 0.80 [0.46, 1.39], p = 0.425).
  
  
  CONCLUSIONS
  The association between CRP concentration and CAC score differed according to HDL-C levels.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: kcmd.sung@samsung.com.
authors.forename: K-C
authors.initials: KC
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul's Hospital, Seoul, Republic of Korea.
authors.forename: E-J
authors.initials: EJ
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: J
authors.initials: J
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mokdong Hospital, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: W B
authors.initials: WB
authors.lastname: Pyun
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, College of Medicine, Yonsei University, Seoul, Republic of Korea.
authors.forename: S-M
authors.initials: SM
authors.lastname: Kang
authors.affiliation: Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Rosenson
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis; D002097:C-Reactive Protein / Q000378:metabolism*; D002118:Calcium / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D003430:Cross-Sectional Studies; D064368:Healthy Volunteers; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002097:C-Reactive Protein; D002118:Calcium
keywords: Atherosclerosis; CRP; Cardio-metabolic risk factors; Cardiovascular disease (CVD); Coronary artery calcium (CAC) score; HDL-C