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Diagnostic performance of plasma high sensitive C-reactive protein in detecting three-vessel coronary artery disease: modification by apolipoprotein E genotype.
Scand J Clin Lab Invest. 2008; 68(8):714-9.SJ

Abstract

OBJECTIVES

Plasma high sensitive C-reactive protein (hsCRP) concentration is an important clinical test of systemic inflammation and, like apoE epsilon4 allele, an important risk factor of coronary artery disease (CAD). We investigated whether the diagnostic performance of plasma hsCRP in detecting severe 3-vessel CAD may be modified by apoE epsilon4 carrier status.

METHODS

The study population (Angiography and Genes Study) comprised 485 Finnish subjects (336 men and 149 women, mean age 64.0+/-1.0) undergoing coronary angiography. ApoE genotypes were determined by the PCR-based method and by hsCRP using an automatic analyser.

RESULTS

The diagnostic performance of hsCRP concentration in distinguishing 3-vessel CAD from its less widespread forms (non-3-vessel CAD) was assessed by receiver operating characteristic curve (ROC) analysis separately in apoE epsilon4 non-carriers and epsilon4 carriers. ROC analysis showed that hsCRP predicted 3-vessel CAD in apoE epsilon4 non-carriers (AUC 0.646; SE 0.035; p = 0.0001; 95 % CI 0.578-0.714) but not in epsilon4 carriers (AUC 0.518; SE 0.049; p = 0.719; 95 % CI 0.422-0.615). Multinomial logistic regression analysis revealed a significant (p<0.05) apoE epsilon4 group versus hsCRP group (<1.0 mg/L/>or=1.0 mg/L) interaction in relation to incidence of 3-vessel CAD. In apoE epsilon4 non-carriers, high hsCRP (>or=1.0 mg/L) was significantly (OR 2.1; 95 % CI 1.233-3.562; p = 0.006) associated with high incidence of 3-vessel CAD after adjustment for major CAD risk factors.

CONCLUSION

The diagnostic performance of hsCRP in distinguishing 3-vessel CAD from less extensive forms of coronary atherosclerosis is more accurate in a group of subjects without the apoE epsilon4 allele than in patients with it.

Authors+Show Affiliations

Heart Center, Tampere University Hospital and Tampere University Medical School, Tampere, Finland. ari.mennander@pshp.fiNo affiliation info availableNo 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

18609102

Citation

Mennander, Ari, et al. "Diagnostic Performance of Plasma High Sensitive C-reactive Protein in Detecting Three-vessel Coronary Artery Disease: Modification By Apolipoprotein E Genotype." Scandinavian Journal of Clinical and Laboratory Investigation, vol. 68, no. 8, 2008, pp. 714-9.
Mennander A, Kuukasjärvi P, Laurikka J, et al. Diagnostic performance of plasma high sensitive C-reactive protein in detecting three-vessel coronary artery disease: modification by apolipoprotein E genotype. Scand J Clin Lab Invest. 2008;68(8):714-9.
Mennander, A., Kuukasjärvi, P., Laurikka, J., Nikus, K., Karhunen, P. J., Tarkka, M., & Lehtimäki, T. (2008). Diagnostic performance of plasma high sensitive C-reactive protein in detecting three-vessel coronary artery disease: modification by apolipoprotein E genotype. Scandinavian Journal of Clinical and Laboratory Investigation, 68(8), 714-9. https://doi.org/10.1080/00365510802172145
Mennander A, et al. Diagnostic Performance of Plasma High Sensitive C-reactive Protein in Detecting Three-vessel Coronary Artery Disease: Modification By Apolipoprotein E Genotype. Scand J Clin Lab Invest. 2008;68(8):714-9. PubMed PMID: 18609102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic performance of plasma high sensitive C-reactive protein in detecting three-vessel coronary artery disease: modification by apolipoprotein E genotype. AU - Mennander,Ari, AU - Kuukasjärvi,Pekka, AU - Laurikka,Jari, AU - Nikus,Kjell, AU - Karhunen,Pekka J, AU - Tarkka,Matti, AU - Lehtimäki,Terho, PY - 2008/7/9/pubmed PY - 2009/1/24/medline PY - 2008/7/9/entrez SP - 714 EP - 9 JF - Scandinavian journal of clinical and laboratory investigation JO - Scand J Clin Lab Invest VL - 68 IS - 8 N2 - OBJECTIVES: Plasma high sensitive C-reactive protein (hsCRP) concentration is an important clinical test of systemic inflammation and, like apoE epsilon4 allele, an important risk factor of coronary artery disease (CAD). We investigated whether the diagnostic performance of plasma hsCRP in detecting severe 3-vessel CAD may be modified by apoE epsilon4 carrier status. METHODS: The study population (Angiography and Genes Study) comprised 485 Finnish subjects (336 men and 149 women, mean age 64.0+/-1.0) undergoing coronary angiography. ApoE genotypes were determined by the PCR-based method and by hsCRP using an automatic analyser. RESULTS: The diagnostic performance of hsCRP concentration in distinguishing 3-vessel CAD from its less widespread forms (non-3-vessel CAD) was assessed by receiver operating characteristic curve (ROC) analysis separately in apoE epsilon4 non-carriers and epsilon4 carriers. ROC analysis showed that hsCRP predicted 3-vessel CAD in apoE epsilon4 non-carriers (AUC 0.646; SE 0.035; p = 0.0001; 95 % CI 0.578-0.714) but not in epsilon4 carriers (AUC 0.518; SE 0.049; p = 0.719; 95 % CI 0.422-0.615). Multinomial logistic regression analysis revealed a significant (p<0.05) apoE epsilon4 group versus hsCRP group (<1.0 mg/L/>or=1.0 mg/L) interaction in relation to incidence of 3-vessel CAD. In apoE epsilon4 non-carriers, high hsCRP (>or=1.0 mg/L) was significantly (OR 2.1; 95 % CI 1.233-3.562; p = 0.006) associated with high incidence of 3-vessel CAD after adjustment for major CAD risk factors. CONCLUSION: The diagnostic performance of hsCRP in distinguishing 3-vessel CAD from less extensive forms of coronary atherosclerosis is more accurate in a group of subjects without the apoE epsilon4 allele than in patients with it. SN - 1502-7686 UR - https://www.unboundmedicine.com/medline/citation/18609102/Diagnostic_performance_of_plasma_high_sensitive_C_reactive_protein_in_detecting_three_vessel_coronary_artery_disease:_modification_by_apolipoprotein_E_genotype_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365510802172145 DB - PRIME DP - Unbound Medicine ER -