C-reactive protein and angiographic characteristics of stable and unstable coronary artery disease: Data from the prospective PREVEND cohort

Autor: Wiek H. van Gilst, Jan G.P. Tijssen, Stephan J. L. Bakker, Christiane A. Geluk, René A. Tio, W. Arnold Dijk, Rene B. van Dijk, Wendy J. Post, Paul E. de Jong, Felix Zijlstra, Hans L. Hillege
Přispěvatelé: Science in Healthy Ageing & healthcaRE (SHARE), Life Course Epidemiology (LCE), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Lifestyle Medicine (LM), Groningen Kidney Center (GKC), Vascular Ageing Programme (VAP), ACS - Amsterdam Cardiovascular Sciences, Cardiology
Jazyk: angličtina
Rok vydání: 2008
Předmět:
unstable plaque
Male
medicine.medical_specialty
ACUTE MYOCARDIAL-INFARCTION
Heart disease
Population
Myocardial Infarction
HEART-DISEASE
Coronary Artery Disease
Coronary Angiography
plaque morphology
Coronary artery disease
PLAQUE RUPTURE
Internal medicine
Intravascular ultrasound
medicine
INTRAVASCULAR ULTRASOUND
risk factors
Humans
ST-SEGMENT ELEVATION
Myocardial infarction
Prospective Studies
education
Prospective cohort study
Aged
Proportional Hazards Models
education.field_of_study
medicine.diagnostic_test
biology
MULTIPLE COMPLEX STENOSES
business.industry
C-reactive protein
Hazard ratio
Middle Aged
medicine.disease
ANGINA-PECTORIS
C-Reactive Protein
Coronary Occlusion
CARDIOVASCULAR-DISEASE
Case-Control Studies
Cardiology
biology.protein
RISK-FACTORS
Female
ATHEROSCLEROTIC PLAQUE
Cardiology and Cardiovascular Medicine
business
CRP
Zdroj: ATHEROSCLEROSIS, 196(1), 372-382. ELSEVIER IRELAND LTD
Atherosclerosis, 196(1), 372-382. Elsevier Ireland Ltd
ISSN: 0021-9150
DOI: 10.1016/j.atherosclerosis.2006.11.013
Popis: Aims: High sensitive-C-reactive protein (hs-CRP) is associated with coronary risk, which may be explained by an association with (unstable) coronary artery disease (CAD). Until now, histopathological and angiographic studies have failed to consistently demonstrate a strong relationship. However, most of these studies were limited by a cross-sectional design. Our aim was to prospectively evaluate the association between hs-CRP and plaque instability. Therefore, firstly, we investigated the relation between hs-CRP measured long before coronary angiography (CAG) and angiographic characteristics of stable and unstable CAD. In addition, we investigated the association with coronary events during follow up in the total PREVEND population.Methods and results: Of the population based Prevention of Renal and Vascular Endstage Disease (PREVEND) study, 8139 subjects without previous documented CAD were followed for the incidence of CAG and coronary events from 1997 to 2003. For the qualitative angiographic analysis, 216 CAGs were available. Mean time to CAG was 37 +/- 19 months. The 864 coronary vessels were graded as follows: 436 coronary vessels as normal, 175 as non-obstructive CAD, 179 as stable obstructive CAD and 74 as unstable obstructive CAD. Multilevel ordinal regression analysis was performed to study associations between baseline clinical variables and angiographic findings. Hs-CRP contributed significantly to the multivariate model after adjustment for age, gender, smoking, lipids and blood pressure. In 8139 subjects, 201 (2.5%) first coronary events occurred during follow up. Cox survival analysis showed age- and sex-adjusted hazard ratios for hs-CRP 1-3 and > 3 mg/L of, respectively, 1.26 (95% CI 0.67-2.40) and 3.16 (95% CI 1.26-3.16), relative to hs-CRP Conclusion: In the prospective PREVEND study of subjects without previous documented CAD, hs-CRP levels at baseline were associated with angiographic characteristics and clinical consequences of plaque instability during follow up. This observation supports the concept that hs-CRP significantly contributes to coronary atherogenesis. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
Databáze: OpenAIRE
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