High-sensitivity C-reactive protein is not associated with carotid intima-media progression: the carotid atherosclerosis progression study.

Abstract

BACKGROUND AND PURPOSE:

It is unclear whether elevated serum C-reactive protein (CRP) is causal to the initiation and progression of atherosclerosis. We undertook a prospective longitudinal cohort study to address this question.

METHODS:

In a population-based sample of 3122 subjects, we measured carotid intima media thickness (IMT) at baseline and after 3 years and surveyed clinical events. Associations between baseline high-sensitivity CRP (hs-CRP) and baseline IMT, and IMT progression were determined before and after controlling for vascular risk factors. The relationship between baseline IMT and clinical events during follow up was determined.

RESULTS:

All vascular risk factors were significantly associated with hs-CRP (P<0.001). Hs-CRP was significantly associated with baseline IMT in all carotid segments (P<0.001), but this association was no longer significant after controlling for age, gender, and cardiovascular risk factors. Hs-CRP was not related to individual IMT progression. Interactions between hs-CRP and body mass index, HbA1c, or blood pressure showed no association with IMT progression. Baseline hs-CRP was related to the risk of clinical events (myocardial infarction or stroke or death, hazard ratio of 1.22 per mg/L hs-CRP increase, 95% CI: 1.07 to 1.39, P=0.004, adjusted for age and gender), but this association was not significant after controlling for age, gender, and cardiovascular risk factors (1.59, 95% CI: 0.96 to 2.64, P=0.072).

CONCLUSIONS:

Our results suggest that hs-CRP is not an independent causal factor for the initiation and progression of early atherosclerotic changes of the carotid arteries. Univariate associations between hs-CRP and IMT were largely explained by confounding by age, gender, and cardiovascular risk factors.

• Authors: Matthias W Lorenz, Peter Karbstein, Hugh S Markus, Matthias Sitzer
• Journal: Stroke (Stroke) Vol. 38 Issue 6 Pg. 1774-9 (Jun 2007) ISSN: 1524-4628 [Electronic] United States
• PMID: 17446427 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• C-Reactive Protein

Topics

• Adult
• Aged
• C-Reactive Protein (metabolism)
• Carotid Arteries (pathology)
• Carotid Artery Diseases (blood, pathology)
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Risk Factors
• Tunica Intima (pathology)
• Tunica Media (pathology)