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C-reactive protein modulates risk prediction based on the Framingham Score: implications for future risk assessment: results from a large cohort study in southern Germany.
Circulation. 2004 Mar 23; 109(11):1349-53.Circ

Abstract

BACKGROUND

The Framingham Coronary Heart Disease (CHD) prediction score is recommended for global risk assessment in subjects prone to CHD. Recently, C-reactive protein (CRP) has emerged as an independent predictor of CHD. We sought to assess the potential of CRP measurements to enhance risk prediction based on the Framingham Risk Score (FRS) in a large cohort of middle-aged men from the general population.

METHODS AND RESULTS

We measured CRP and traditional cardiovascular risk factors at baseline in 3435 white men of German nationality, 45 to 74 years of age. All men were drawn from 3 random samples of the general population in the Augsburg area located in Southern Germany in 1984 to 1985, 1989 to 1990, and 1994 to 1995 (response rate, 80%), and the FRS was calculated in all of them. Outcome was defined as nonfatal and fatal coronary events, including sudden cardiac death. During an average follow-up of 6.6 years, a total of 191 coronary events occurred. Cox regression showed a significant contribution of CRP to coronary event risk prediction independent of the FRS (P=0.0002). In stratified analysis for 5 categories of FRS, CRP significantly added prognostic information to the FRS in subjects in 2 intermediate risk categories (P=0.03 and P=0.02).

CONCLUSIONS

Our results suggest that CRP enhances global coronary risk as assessed by the FRS, especially in intermediate risk groups. This might have implications for future risk assessment.

Authors+Show Affiliations

Department of Internal Medicine II, Cardiology, University of Ulm Medical Center, Robert-Koch Str 8, D-89081 Ulm, Germany. wolfgang.koenig@medizin.uni-ulm.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

15023871

Citation

Koenig, Wolfgang, et al. "C-reactive Protein Modulates Risk Prediction Based On the Framingham Score: Implications for Future Risk Assessment: Results From a Large Cohort Study in Southern Germany." Circulation, vol. 109, no. 11, 2004, pp. 1349-53.
Koenig W, Löwel H, Baumert J, et al. C-reactive protein modulates risk prediction based on the Framingham Score: implications for future risk assessment: results from a large cohort study in southern Germany. Circulation. 2004;109(11):1349-53.
Koenig, W., Löwel, H., Baumert, J., & Meisinger, C. (2004). C-reactive protein modulates risk prediction based on the Framingham Score: implications for future risk assessment: results from a large cohort study in southern Germany. Circulation, 109(11), 1349-53.
Koenig W, et al. C-reactive Protein Modulates Risk Prediction Based On the Framingham Score: Implications for Future Risk Assessment: Results From a Large Cohort Study in Southern Germany. Circulation. 2004 Mar 23;109(11):1349-53. PubMed PMID: 15023871.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - C-reactive protein modulates risk prediction based on the Framingham Score: implications for future risk assessment: results from a large cohort study in southern Germany. AU - Koenig,Wolfgang, AU - Löwel,Hannelore, AU - Baumert,Jens, AU - Meisinger,Christa, Y1 - 2004/03/15/ PY - 2004/3/17/pubmed PY - 2004/7/9/medline PY - 2004/3/17/entrez SP - 1349 EP - 53 JF - Circulation JO - Circulation VL - 109 IS - 11 N2 - BACKGROUND: The Framingham Coronary Heart Disease (CHD) prediction score is recommended for global risk assessment in subjects prone to CHD. Recently, C-reactive protein (CRP) has emerged as an independent predictor of CHD. We sought to assess the potential of CRP measurements to enhance risk prediction based on the Framingham Risk Score (FRS) in a large cohort of middle-aged men from the general population. METHODS AND RESULTS: We measured CRP and traditional cardiovascular risk factors at baseline in 3435 white men of German nationality, 45 to 74 years of age. All men were drawn from 3 random samples of the general population in the Augsburg area located in Southern Germany in 1984 to 1985, 1989 to 1990, and 1994 to 1995 (response rate, 80%), and the FRS was calculated in all of them. Outcome was defined as nonfatal and fatal coronary events, including sudden cardiac death. During an average follow-up of 6.6 years, a total of 191 coronary events occurred. Cox regression showed a significant contribution of CRP to coronary event risk prediction independent of the FRS (P=0.0002). In stratified analysis for 5 categories of FRS, CRP significantly added prognostic information to the FRS in subjects in 2 intermediate risk categories (P=0.03 and P=0.02). CONCLUSIONS: Our results suggest that CRP enhances global coronary risk as assessed by the FRS, especially in intermediate risk groups. This might have implications for future risk assessment. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15023871/C_reactive_protein_modulates_risk_prediction_based_on_the_Framingham_Score:_implications_for_future_risk_assessment:_results_from_a_large_cohort_study_in_southern_Germany_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000120707.98922.E3?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -