title: High sensitive C-reactive protein (hsCRP), cardiovascular events and mortality in the aged: a prospective 9-year follow-up study.
abstract: OBJECTIVE
  The clinical utility of application of hsCRP categorization and the association of hsCRP with vascular disease (VD) events are less studied among the aged. This study investigated whether an elevated hsCRP has an additive effect on conventional vascular risk factors in predicting cardiovascular morbidity and all-cause mortality among the aged.
  
  
  RESULTS
  a prospective population-based study with a 9-year follow-up among persons aged ≥64 and without VD and C-reactive protein (CRP)<10mg/L at baseline (n=771). Adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for VDs and all-cause mortality predicted by hsCRP level were estimated. During the follow-up, there were 151 major VD events, and 217 subjects died. After the adjustment for age and gender or risk factors related to VD events or a metabolic syndrome (MetS), hsCRP was not related to incident VD events (HR 1.14, 95% CI 0.96-1.35, p=.127 or 1.11, 0.94-1.32, p=.212, respectively). hsCRP predicted all-cause mortality after the adjustment for age and gender (1.18, 1.03-1.36, p=.020) and multiple factors (1.16, 1.00-1.33, p=.046) but not beyond conventional risk factors. High risk participants (hsCRP 3.0-9.9mg/L) had higher age and gender adjusted (1.50, 1.07-2.10, p=.018) and tended to have higher risk factor adjusted all-cause mortality (1.41, 1.00-2.00, p=.052) compared with low risk participants (hsCRP<1mg/L).
  
  
  CONCLUSIONS
  hsCRP may not be useful in prediction of cardiovascular events.
authors.affiliation: Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland; Naantali Health Centre, Naantali, Finland.
authors.forename: Marikka
authors.initials: M
authors.lastname: Kuoppamäki
authors.affiliation: Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland; Härkätie Health Centre, Lieto, Finland; Unit of Family Medicine, Turku University Hospital, Turku, Finland. Electronic address: majosa@utu.fi.
authors.forename: Marika
authors.initials: M
authors.lastname: Salminen
authors.affiliation: Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland.
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.affiliation: Mehiläinen Oy, Finland.
authors.forename: Kerttu
authors.initials: K
authors.lastname: Irjala
authors.affiliation: Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, Finland.
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Kivelä
authors.affiliation: Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland; Department of Internal Medicine, Turku City Hospital, Turku, Finland.
authors.forename: Ismo
authors.initials: I
authors.lastname: Räihä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein
keywords: Aged; High sensitive C-reactive protein; Risk factors; Vascular disease