An Assessment of Incremental Coronary Risk Prediction Using C-Reactive Protein and Other Novel Risk Markers

Folsom, Aaron R.; Chambless, Lloyd E.; Ballantyne, Christie M.; Coresh, Josef; Heiss, Gerardo; Wu, Kenneth K.; Boerwinkle, Eric; Mosley, Thomas H.; Sorlie, Paul D.; Diao, Guoqing; Sharrett, A. Richey

doi:10.1001/archinte.166.13.1368

Cited by 331 publications

(205 citation statements)

References 37 publications

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“…Comparisons of the value of newer and traditional risk markers have shown little additional prediction by including the new markers [37][38][39]. The present results support this contention and show that traditional risk markers provide excellent prediction of prognosis.…”

Section: Discussionsupporting

confidence: 77%

Risk prediction in stable angina pectoris

Kahan

Forslund

Held

et al. 2012

Eur J Clin Investigation

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Section: Discussionsupporting

confidence: 77%

Risk prediction in stable angina pectoris

Kahan

Forslund

Held

et al. 2012

Eur J Clin Investigation

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“…A further limitation of this study is that it included a comparison to only the traditional risk factors considered by the NCEP guidelines; future studies could also compare the GRS with emerging risk factors. 33 Finally the population-attributable risk of a high GRS is lower than that of the more prevalent traditional risk factors.…”

Section: Discussionmentioning

confidence: 99%

Five common gene variants identify elevated genetic risk for coronary heart disease

Bare¹,

Morrison

Rowland³

et al. 2007

Genetics in Medicine

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Purpose: Because multiple genetic variants influence risk for coronary heart disease, we combined multiple variants that had been associated with coronary heart disease in several studies into a genetic risk score and asked whether a high genetic risk score would be significantly associated with coronary heart disease after accounting for traditional risk factors. Methods: We considered five variants that were associated with coronary heart disease in two studies and confirmed in the Atherosclerosis Risk in Communities study: rs20455 (KIF6), rs3900940 (MYH15), rs7439293 (PALLD), rs2298566 (SNX19), and rs1010 (VAMP8). We calculated a genetic risk score for each Atherosclerosis Risk in Communities study participant and estimated the hazard ratio for incident coronary heart disease of a high genetic risk score (compared with not-high) in Cox models that adjusted for traditional risk factors during a median of 13 years of follow-up. Results: For white participants with a high genetic risk score (4% of the 9129 whites), compared with those without a high genetic risk score, the hazard ratio for incident coronary heart disease was 1.57 (95% confidence interval 1.21-2.04; P ϭ 0.001). Internal validation using bootstrap samples estimated that a hazard ratio of 1.43 could be expected in external populations. Conclusions:After adjusting for traditional risk factors, those with a high genetic risk score had a 57% increased risk of incident coronary heart disease in the Atherosclerosis Risk in Communities study. Genet Med 2007:9(10):682-689.

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“…Increasingly, studies in primarily white-American populations suggest that inflammatory markers such as CRP levels have shown to independently predict cardiovascular disease and adverse cardiovascular outcomes (14)(15)(16)(17). Although the magnitude of the predictive contribution of inflammation beyond that of traditional cardiovascular risk factors is being debated (32,33), one of the mechanisms by which obesity and adiposity confer cardiovascular risk is likely through heightened inflammation. Our findings suggest that the relationship between BMI and CRP levels is comparable among white, African-American, and Hispanic populations in the United States and that visceral adiposity, measured by waist circumference, may be more adversely associated with inflammation in Mexican-Hispanic women than in white women.…”

Section: Discussionmentioning

confidence: 99%

Obesity and C-reactive Protein Levels Among White, Black, and Hispanic US Adults

Wee¹,

Mukamal²,

Huang³

et al. 2008

Obesity

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Objective-Studies suggest that obesity's adverse impact on cardiovascular mortality may be reduced in African Americans relative to white Americans. We examined whether obesity's association with novel cardiovascular risk factors such as C-reactive protein (CRP) also varies by race and ethnicity.Methods and Procedures-We analyzed data from 10,492 white, African-American, and Hispanic-American participants of the 1999-2004 National Health and Nutrition Examination Survey, who were aged 20 years and older, with a BMI ≥18.5 kg/m 2 and CRP ≤10 mg/l. We fit sexspecific multivariable models of the association of BMI or waist circumference with log CRP levels and tested for interactions of BMI or waist circumference with race/ethnicity.Results-Higher BMI was significantly associated with higher CRP in all racial/ethnic groups for both men and women (P > 0.05 for BMI-race/ethnicity interaction) before and after adjustment for age, education, and health behaviors. Larger waist circumference was also associated with higher CRP levels in all racial/ethnic groups before and after adjustment; among women, the relationship was strongest for Mexican Hispanics (P < 0.01 for waist circumference-race/ethnicity interaction). Results were similar after additional adjustment for medications that might affect CRP levels.

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An Assessment of Incremental Coronary Risk Prediction Using C-Reactive Protein and Other Novel Risk Markers

Abstract: Our findings suggest that routine measurement of these novel markers is not warranted for risk assessment. On the other hand, our findings reinforce the utility of major, modifiable risk factor assessment to identify individuals at risk for CHD for preventive action.

Cited by 331 publications

References 37 publications

Risk prediction in stable angina pectoris

Risk prediction in stable angina pectoris

Five common gene variants identify elevated genetic risk for coronary heart disease

Obesity and C-reactive Protein Levels Among White, Black, and Hispanic US Adults

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