title: C-reactive protein and cardiovascular disease in East asians: a systematic review.
abstract: Elevated C-reactive protein (CRP) levels are associated with an increased risk of cardiovascular disease (CVD) in Caucasians; however, evidence is lacking for East Asians, who have low CRP levels. PubMed and Google Scholar searches were conducted (1966 through September 2014), and eight prospective studies in East Asian countries (China, Hong Kong, Japan, Korea, Macao, Mongolia, and Taiwan) that documented risk ratios of elevated CRP for CVD were included for meta-analysis with random-effects models. The overall association between CRP levels and stroke was significant in six studies (risk ratio = 1.40 [95% confidence interval {CI}, 1.10-1.77], P = 0.008). The association with ischemic stroke was more evident in subgroup analyses. For coronary heart disease (CHD) and CVD, the risk ratio was 1.75 (95% CI, 0.96-3.19, P = 0.07) and 1.76 (95% CI, 1.29-2.40, P < 0.001), respectively. Although East Asians have low CRP levels, this meta-analysis shows that elevated CRP levels were significantly associated with an increased risk of stroke, primarily ischemic stroke.
authors.affiliation: Department of Basic Nursing and Health Science, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Saito
authors.affiliation: Department of Basic Medical Research and Education, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Koutatsu
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Department of Public Health, Ehime University Graduate School of Medicine, Toon, Ehime, Japan. ; Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Eguchi
keywords: C-reactive protein; East Asia; cardiovascular disease; systematic review