Association of high sensitive C-reactive protein with coronary heart disease: a Mendelian randomization study

Abstract

ObjectivesWhether high sensitivity C-reactive protein (hs-CRP) has a causal effect on coronary heart disease (CHD) is unclear. This study investigated the causal effect of hs-CRP on CHD risk using Mendelian Randomization (MR) analysis.MethodsA total of 3802 subjects were recruited in the follow-up study. Linear regression model was used to evaluate the relationship between CRP polymorphisms and hs-CRP. Survival receiver operator characteristic curve method was used to explore the cut-off of hs-CRP on CHD incidence. Cox regression model was applied to detect the association of hs-CRP with CHD by calculating the hazard ratio (HR) and 95% confidence interval (CI). Rs1205 and rs876537 in CRP were selected as instrumental variables in MR analysis.ResultsDuring a median follow-up time of 5.01 years, 98 CHD incidence was identified (47.03/104 person-years). Hs-CRP was significantly increased among rs1205 and rs876537 genotypes with r values of 0.064 and 0.066, respectively. Hs-CRP 1.08 mg/L was identified as the cut-off value with a maximum value of sensitivity and specificity on prediction of CHD. Participants with ≥1.08 mg/L of hs-CRP has a higher risk of CHD incidence than that of participants with < 1.08 mg/L, the adjusted HR (95% CI) was 1.69 (1.11–2.60) with a P value of 0.016. No significant casual association was observed between hs-CRP and CHD with a P value of 0.777.ConclusionsThe association between hs-CRP and CHD is unlikely to be causal, hs-CRP might be a predictor for incidence of CHD in general population.

Circulating Myeloperoxidase (MPO)-DNA complexes as marker for Neutrophil Extracellular Traps (NETs) levels and the association with cardiovascular risk factors in the general population

“…Also, the differences in MPO-DNA complex levels between participants with and without prevalent CVD were small. However, in previous studies on CRP levels and the risk of CVD, small elevations in CRP levels within the normal reference range have been shown to be associated with CHD [ 38 – 40 ]. Thus, this indicates that low grade inflammation is a risk factor for CHD.…”

Clinical biomarkers and associations with healthspan and lifespan: Evidence from observational and genetic data

“…Elevated circulating CRP is a risk factor for CVDs; [40] yet genetically predicted CRP was not associated with coronary heart disease [ 41 , 42 ]. Interestingly, our results showed that an elevated serum CRP concentration was associated with higher risks of any chronic disease and death, whereas genetic predisposition to higher CRP indicated lower death risk.…”

Hs-CRP to albumin ratio predicts mortality of acute myocardial infarction patients with chronic kidney disease undergoing coronary angiography

“…In ammation plays a key role in the formation, development and rupture of atherosclerotic plaques. In 2019, Zhuang conducted a randomized clinical trial, enrolling 3802 subjects followed up for 5.01 years, and it was found that hs-CRP was positively associated with the incidence of coronary heart disease in the general population [16]. In 2014, Daniel's study identi ed hs-CRP as an independent predictive factor of 30-day mortality in STEMI patients [21].…”

“…Studies have shown the CRP to Alb ratio could be used as a sensitive marker of in ammatory process and predicting the prognosis of patients with AMI, critical illness, malignant tumor and severe septicemia [10][11][12][13]. Thus, the hs-CRP to Alb ratio (HCAR), calculated by dividing hs-CRP by Alb obtained from clinical blood biochemical examination, may be more valuable in indicating higher residual in ammation with malnutrition status than either alone [14][15][16].…”