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The value of C-reactive protein in cardiovascular risk prediction: the Rotterdam Study.
Arch Intern Med. 2003 Jun 09; 163(11):1323-8.AI

Abstract

BACKGROUND

Epidemiologic studies have shown that C-reactive protein (CRP) is a risk factor for coronary heart disease. Whether routine measurement of CRP has a role in the prediction of future coronary disease in everyday clinical practice has not yet been investigated.

METHODS

Within the Rotterdam Study, a population-based cohort study of 7983 men and women 55 years and older, we conducted a nested case-control study to investigate the value of CRP in coronary disease prediction. Data are based on 157 participants who experienced a myocardial infarction during follow-up and 500 randomly selected controls. High-sensitivity CRP and traditional cardiovascular risk factors were measured at baseline.

RESULTS

The age- and sex-adjusted relative risk of myocardial infarction for subjects in the highest quartile of the population distribution of CRP compared with the lowest quartile was 2.0 (95% confidence interval, 1.1-3.4). After additional adjustment for traditional cardiovascular risk factors, the increase in risk largely disappeared (odds ratio, 1.2; 95% confidence interval, 0.6-2.2). Adding CRP to a coronary disease risk function based on risk factors that are routinely assessed in clinical practice or to the Framingham risk function did not improve the area under the receiver operating characteristic curve of these risk functions. Sensitivity and specificity of both risk functions, computed after dichotomizing the estimated disease probabilities using prespecified cutoff points, hardly improved when CRP was added.

CONCLUSION

Measurement of CRP in elderly people has no additional value in coronary disease risk prediction when traditional cardiovascular risk factors are known.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12796068

Citation

van der Meer, Irene M., et al. "The Value of C-reactive Protein in Cardiovascular Risk Prediction: the Rotterdam Study." Archives of Internal Medicine, vol. 163, no. 11, 2003, pp. 1323-8.
van der Meer IM, de Maat MP, Kiliaan AJ, et al. The value of C-reactive protein in cardiovascular risk prediction: the Rotterdam Study. Arch Intern Med. 2003;163(11):1323-8.
van der Meer, I. M., de Maat, M. P., Kiliaan, A. J., van der Kuip, D. A., Hofman, A., & Witteman, J. C. (2003). The value of C-reactive protein in cardiovascular risk prediction: the Rotterdam Study. Archives of Internal Medicine, 163(11), 1323-8.
van der Meer IM, et al. The Value of C-reactive Protein in Cardiovascular Risk Prediction: the Rotterdam Study. Arch Intern Med. 2003 Jun 9;163(11):1323-8. PubMed PMID: 12796068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The value of C-reactive protein in cardiovascular risk prediction: the Rotterdam Study. AU - van der Meer,Irene M, AU - de Maat,Moniek P M, AU - Kiliaan,Amanda J, AU - van der Kuip,Deirdre A M, AU - Hofman,Albert, AU - Witteman,Jacqueline C M, PY - 2003/6/11/pubmed PY - 2003/6/27/medline PY - 2003/6/11/entrez SP - 1323 EP - 8 JF - Archives of internal medicine JO - Arch Intern Med VL - 163 IS - 11 N2 - BACKGROUND: Epidemiologic studies have shown that C-reactive protein (CRP) is a risk factor for coronary heart disease. Whether routine measurement of CRP has a role in the prediction of future coronary disease in everyday clinical practice has not yet been investigated. METHODS: Within the Rotterdam Study, a population-based cohort study of 7983 men and women 55 years and older, we conducted a nested case-control study to investigate the value of CRP in coronary disease prediction. Data are based on 157 participants who experienced a myocardial infarction during follow-up and 500 randomly selected controls. High-sensitivity CRP and traditional cardiovascular risk factors were measured at baseline. RESULTS: The age- and sex-adjusted relative risk of myocardial infarction for subjects in the highest quartile of the population distribution of CRP compared with the lowest quartile was 2.0 (95% confidence interval, 1.1-3.4). After additional adjustment for traditional cardiovascular risk factors, the increase in risk largely disappeared (odds ratio, 1.2; 95% confidence interval, 0.6-2.2). Adding CRP to a coronary disease risk function based on risk factors that are routinely assessed in clinical practice or to the Framingham risk function did not improve the area under the receiver operating characteristic curve of these risk functions. Sensitivity and specificity of both risk functions, computed after dichotomizing the estimated disease probabilities using prespecified cutoff points, hardly improved when CRP was added. CONCLUSION: Measurement of CRP in elderly people has no additional value in coronary disease risk prediction when traditional cardiovascular risk factors are known. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/12796068/The_value_of_C_reactive_protein_in_cardiovascular_risk_prediction:_the_Rotterdam_Study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/163/pg/1323 DB - PRIME DP - Unbound Medicine ER -