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Utility of C-reactive protein for cardiovascular risk stratification across three age groups in subjects without existing cardiovascular diseases.
Am J Cardiol. 2009 Aug 15; 104(4):538-42.AJ

Abstract

The relative utility of conventional and novel risk factors in predicting cardiovascular disease (CVD) in relation to age remains unclear. We examined the discriminative ability of C-reactive protein (CRP) and Framingham risk score across young (35 to 50 years), middle (51 to 65 years), and older (> or =65 years) aged participants from the Scottish Health Surveys (n = 5,944, 44.5% men). CRP data and conventional risk factors were collected at baseline. During an average follow-up of 7.1 years, 308 CVD events (a composite of fatal and nonfatal events incorporating acute myocardial infarction, coronary artery bypass surgery, percutaneous coronary angioplasty, stroke, and heart failure) occurred. The log CRP/SD predicted the risk of CVD events in middle-age (hazard ratio 2.20, 95% confidence interval 1.34 to 3.61) and older (hazard ratio 1.85, 95% confidence interval 1.23 to 2.78) participants, after adjustment for the Framingham risk score. Using receiver operating characteristic (ROC) curves, the area under the curve for the Framingham risk factor model for predicting CVD events was greater in the younger (ROC 0.78) and middle-age (ROC 0.72) participants than in the older participants (ROC 0.59), although the discriminative ability was not substantially improved by adding the CRP data. In conclusion, our results have demonstrated the steadily decreasing predictive value of conventional risk factors with advancing age, although CRP has limited additive value for CVD risk stratification. Our results provide validation of the recently devised Framingham risk factor algorithm for use in primary care in participants <65 years old.

Authors+Show Affiliations

Department of Epidemiology and Public Health, University College London, London, United Kingdom. m.hamer@ucl.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19660608

Citation

Hamer, Mark, et al. "Utility of C-reactive Protein for Cardiovascular Risk Stratification Across Three Age Groups in Subjects Without Existing Cardiovascular Diseases." The American Journal of Cardiology, vol. 104, no. 4, 2009, pp. 538-42.
Hamer M, Chida Y, Stamatakis E. Utility of C-reactive protein for cardiovascular risk stratification across three age groups in subjects without existing cardiovascular diseases. Am J Cardiol. 2009;104(4):538-42.
Hamer, M., Chida, Y., & Stamatakis, E. (2009). Utility of C-reactive protein for cardiovascular risk stratification across three age groups in subjects without existing cardiovascular diseases. The American Journal of Cardiology, 104(4), 538-42. https://doi.org/10.1016/j.amjcard.2009.04.020
Hamer M, Chida Y, Stamatakis E. Utility of C-reactive Protein for Cardiovascular Risk Stratification Across Three Age Groups in Subjects Without Existing Cardiovascular Diseases. Am J Cardiol. 2009 Aug 15;104(4):538-42. PubMed PMID: 19660608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of C-reactive protein for cardiovascular risk stratification across three age groups in subjects without existing cardiovascular diseases. AU - Hamer,Mark, AU - Chida,Yoichi, AU - Stamatakis,Emmanuel, Y1 - 2009/06/18/ PY - 2009/03/18/received PY - 2009/04/11/revised PY - 2009/04/11/accepted PY - 2009/8/8/entrez PY - 2009/8/8/pubmed PY - 2009/8/28/medline SP - 538 EP - 42 JF - The American journal of cardiology JO - Am J Cardiol VL - 104 IS - 4 N2 - The relative utility of conventional and novel risk factors in predicting cardiovascular disease (CVD) in relation to age remains unclear. We examined the discriminative ability of C-reactive protein (CRP) and Framingham risk score across young (35 to 50 years), middle (51 to 65 years), and older (> or =65 years) aged participants from the Scottish Health Surveys (n = 5,944, 44.5% men). CRP data and conventional risk factors were collected at baseline. During an average follow-up of 7.1 years, 308 CVD events (a composite of fatal and nonfatal events incorporating acute myocardial infarction, coronary artery bypass surgery, percutaneous coronary angioplasty, stroke, and heart failure) occurred. The log CRP/SD predicted the risk of CVD events in middle-age (hazard ratio 2.20, 95% confidence interval 1.34 to 3.61) and older (hazard ratio 1.85, 95% confidence interval 1.23 to 2.78) participants, after adjustment for the Framingham risk score. Using receiver operating characteristic (ROC) curves, the area under the curve for the Framingham risk factor model for predicting CVD events was greater in the younger (ROC 0.78) and middle-age (ROC 0.72) participants than in the older participants (ROC 0.59), although the discriminative ability was not substantially improved by adding the CRP data. In conclusion, our results have demonstrated the steadily decreasing predictive value of conventional risk factors with advancing age, although CRP has limited additive value for CVD risk stratification. Our results provide validation of the recently devised Framingham risk factor algorithm for use in primary care in participants <65 years old. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/19660608/Utility_of_C_reactive_protein_for_cardiovascular_risk_stratification_across_three_age_groups_in_subjects_without_existing_cardiovascular_diseases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)00923-0 DB - PRIME DP - Unbound Medicine ER -