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Higher level of systemic C-reactive protein is independently predictive of coronary heart disease in older community-dwelling adults: the three-city study.
J Am Geriatr Soc. 2010 Jan; 58(1):129-35.JA

Abstract

OBJECTIVES

To assess the association between systemic C-reactive protein (CRP) and incident coronary heart disease (CHD) in community-dwelling elderly people.

DESIGN

A French population-based multicenter prospective cohort study.

SETTING

Three cities in France: Bordeaux in the southwest, Dijon in the northeast, and Montpellier in the southeast.

PARTICIPANTS

After 4 years of follow-up, a case-cohort study was designed including 1,004 subjects randomly selected from the initial cohort of 9,294 subjects free of CHD at baseline and 174 subjects who developed first CHD events during follow-up.

MEASUREMENTS

Hazard ratios (HRs) were estimated using a Cox proportional hazard model adapted for the case-cohort design using a CRP level less than 1 mg/L as the reference category.

RESULTS

Of the random sample, 24.3% had a CRP level less than 1.0 mg/L, 45.8% had a CRP level of 1.0 to 2.9 mg/L, and 29.9% had a CRP level of 3.0 to 10.0 mg/L. The HRs for CHD, adjusted for age, sex, and study center, were 1.69 (95% confidence interval (CI)=1.04-2.75) for CRP from 1.0 to 2.9 mg/L and 2.32 (95% CI=1.41-3.82) for CRP from 3.0 to 10.0 mg/L (P for trend <.001). After additional adjustment for smoking, body mass index, diabetes mellitus, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, statin use, and antihypertensive treatment, a baseline CRP of 3.0 to 10.0 mg/L remained associated with risk of CHD (HR=1.87, 95% CI=1.09-3.25), although CRP did not improve the discriminative ability of a predicting model based on traditional risk factors (receiver operating characteristic curves from 0.740 to 0.749).

CONCLUSION

CRP is an independent CHD risk marker but does not improve CHD risk prediction in community-dwelling elderly people.

Authors+Show Affiliations

INSERM U970, Paris Cardiovascular Research Center, Paris, France. Celine.straczek@inserm.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20002508

Citation

Straczek, Celine, et al. "Higher Level of Systemic C-reactive Protein Is Independently Predictive of Coronary Heart Disease in Older Community-dwelling Adults: the Three-city Study." Journal of the American Geriatrics Society, vol. 58, no. 1, 2010, pp. 129-35.
Straczek C, Ducimetiere P, Barberger-Gateau P, et al. Higher level of systemic C-reactive protein is independently predictive of coronary heart disease in older community-dwelling adults: the three-city study. J Am Geriatr Soc. 2010;58(1):129-35.
Straczek, C., Ducimetiere, P., Barberger-Gateau, P., Helmer, C., Ritchie, K., Jouven, X., Carcaillon, L., Amouyel, P., Tzourio, C., & Empana, J. P. (2010). Higher level of systemic C-reactive protein is independently predictive of coronary heart disease in older community-dwelling adults: the three-city study. Journal of the American Geriatrics Society, 58(1), 129-35. https://doi.org/10.1111/j.1532-5415.2009.02625.x
Straczek C, et al. Higher Level of Systemic C-reactive Protein Is Independently Predictive of Coronary Heart Disease in Older Community-dwelling Adults: the Three-city Study. J Am Geriatr Soc. 2010;58(1):129-35. PubMed PMID: 20002508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher level of systemic C-reactive protein is independently predictive of coronary heart disease in older community-dwelling adults: the three-city study. AU - Straczek,Celine, AU - Ducimetiere,Pierre, AU - Barberger-Gateau,Pascale, AU - Helmer,Catherine, AU - Ritchie,Karen, AU - Jouven,Xavier, AU - Carcaillon,Laure, AU - Amouyel,Philippe, AU - Tzourio,Christophe, AU - Empana,Jean-Philippe, Y1 - 2009/12/09/ PY - 2009/12/17/entrez PY - 2009/12/17/pubmed PY - 2010/3/4/medline SP - 129 EP - 35 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 58 IS - 1 N2 - OBJECTIVES: To assess the association between systemic C-reactive protein (CRP) and incident coronary heart disease (CHD) in community-dwelling elderly people. DESIGN: A French population-based multicenter prospective cohort study. SETTING: Three cities in France: Bordeaux in the southwest, Dijon in the northeast, and Montpellier in the southeast. PARTICIPANTS: After 4 years of follow-up, a case-cohort study was designed including 1,004 subjects randomly selected from the initial cohort of 9,294 subjects free of CHD at baseline and 174 subjects who developed first CHD events during follow-up. MEASUREMENTS: Hazard ratios (HRs) were estimated using a Cox proportional hazard model adapted for the case-cohort design using a CRP level less than 1 mg/L as the reference category. RESULTS: Of the random sample, 24.3% had a CRP level less than 1.0 mg/L, 45.8% had a CRP level of 1.0 to 2.9 mg/L, and 29.9% had a CRP level of 3.0 to 10.0 mg/L. The HRs for CHD, adjusted for age, sex, and study center, were 1.69 (95% confidence interval (CI)=1.04-2.75) for CRP from 1.0 to 2.9 mg/L and 2.32 (95% CI=1.41-3.82) for CRP from 3.0 to 10.0 mg/L (P for trend <.001). After additional adjustment for smoking, body mass index, diabetes mellitus, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, statin use, and antihypertensive treatment, a baseline CRP of 3.0 to 10.0 mg/L remained associated with risk of CHD (HR=1.87, 95% CI=1.09-3.25), although CRP did not improve the discriminative ability of a predicting model based on traditional risk factors (receiver operating characteristic curves from 0.740 to 0.749). CONCLUSION: CRP is an independent CHD risk marker but does not improve CHD risk prediction in community-dwelling elderly people. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/20002508/Higher_level_of_systemic_C_reactive_protein_is_independently_predictive_of_coronary_heart_disease_in_older_community_dwelling_adults:_the_three_city_study_ L2 - https://doi.org/10.1111/j.1532-5415.2009.02625.x DB - PRIME DP - Unbound Medicine ER -