Clinical Application of C-Reactive Protein for Cardiovascular Disease Detection and Prevention

Ridker, Paul M.

doi:10.1161/01.cir.0000053730.47739.3c

Cited by 2,179 publications

(1,651 citation statements)

References 53 publications

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“…[25][26][27] Inflamation in acute coronary syndromes is suggested by numerous clinical studies showing increased acute-phase reactants in the serum of patients with unstable angina and those at risk of future myocardial infarction. 28,29 In the present study, the preinterventional peak monocyte count was significantly higher in the ISR group and the reintervention group than in that with no ISR and with no reintervention. Furthermore, significant positive correlations were found between preinterventional peak monocyte count and plaque, media CSA, and plaque burden, and between preinterventional peak monocyte count and follow-up neointima area.…”

Section: Discussionsupporting

confidence: 41%

Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries

et al. 2005

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SummaryBackground: The mechanism of restenosis after stent implantation principally is neointimal hyperplasia. There is evidence that monocytes play a important role in in-stent restenosis (ISR) after stent implantation.Hypothesis: This study assessed the relationship between preinterventional peak monocyte count and neointimal growth after successful stent implantation.Methods: We performed coronary stent implantation in 85 patients (85 de novo lesions). Peripheral blood sample was obtained in all patients every 12 h before coronary angiography for measurement of peripheral monocytes. All patients received angiographic and intravascular ultrasound (IVUS) follow-up at 6 months after stenting.Results: The preinterventional circulating monocyte count was significantly higher in the ISR group than that in the group without ISR (654 ± 62/ vs. 461 ± 222/mm 3 , p < 0.001) and was significantly higher in the reintervention group than that in the no-reintervention group (660 ± 72/ vs. 470 ± 216/mm 3 , p< 0.001). The incidence of ISR and repeat intervention associated with preinterventional monocyte count was highest among the patients in the highest tertile, who were at a 2.64-fold increased risk of ISR and 3.22-fold increased risk of repeat intervention compared with the patients in the lowest tertile. A significant positive correlation was found between preinterventional peak monocyte count and preinterventional plaque

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Section: Discussionsupporting

confidence: 41%

Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries

et al. 2005

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“…CRP levels in blood are a good indicator of the likelihood of acute coronary and cerebral events in both healthy subjects and patients with coronary artery disease. 16,36 CRP is positively associated with BMI and we and others have shown that energy striction and weight loss lowers CRP. 16,37,38 Ziccardi et al 7 found reductions in IL-6, VCAM-1 and ICAM-1 following weight loss of 10 kg however we demonstrated reductions in the ICAM-1 but not VCAM or IL-6.…”

Section: Discussionmentioning

confidence: 74%

Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets

et al. 2005

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OBJECTIVE: Cardiovascular disease is strongly associated with obesity and there is evidence that weight loss has positive effects on cardiovascular disease risk. The aims of this study were to compare meal replacements (MR) with a conventional low-fat diet as weight loss strategies and to examine the effect of weight loss on flow-mediated dilatation (FMD) and other markers of endothelial function in overweight Australians with raised triglycerides (TG) (42 mmol/l). RESEARCH METHODS: Subjects matched for age, gender, fasting plasma TG and body mass index were randomized to two low-fat high-carbohydrate weight loss strategies (both o6000 kJ), one using MR and the other a structured eating plan, control (C). Subjects followed both diets for 3 months. In total, 55 subjects completed the study. FMD, pulse wave velocity and blood pressure (BP) were measured at baseline and at 3 months, as were fasting blood samples for lipids, glucose, insulin, C reactive protein (CRP) and endothelium-derived factors. RESULTS: Mean weight loss was 6.373.7 kg (6.074.2 vs 6.6373.35 kg, MR vs C) with no difference between diet groups. TG, insulin, CRP, plasminogen activator inhibitor 1 (PAI-1) and soluble intracellular adhesion molecule-1 (sICAM1) fell after weight loss, but FMD did not change. Systolic BP fell by 8 mmHg and pulse wave velocity improved. DISCUSSION: In subjects with elevated TG, weight loss resulted in significant improvements in cardiovascular risk markers, particularly endothelium-derived factors (PAI-1 and sICAM1). However, FMD did not improve with weight loss.

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“…However, it has been reported that in most clinical settings, a single CRP assessment is likely to be adequate as long as levels of less than 10 mg/l are observed. 22 Although there are many published papers showing that CRP is a potent risk factor for clinical cardiovascular disease, there is scarcity of clinical data regarding the potential aetiological link between CRP and cardiovascular complications. The associations that we observed between measures of arterial stiffness and CRP add to the evidence that there is a relation between subclinical inflammation and functional alteration of large arterial bed and preclinical arterial remodeling (a true prequel to cardiovascular events).…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein and aortic stiffness and wave reflection in middle-aged and elderly men from the community

et al. 2007

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High plasma C-reactive protein (hs-CRP) levels and arterial stiffness are risk factors for cardiovascular diseases. Pulse wave velocity (PWV) and augmentation index (AIx) have been found to be elevated in patients with vascular inflammation, diabetes mellitus, hypertension, hypercholesterolemia and in smokers. We investigated the relation of high-sensitivity CRP (hs-CRP) with aortic stiffness in 362 men. The levels of hs-CRP were measured using a nephelometric method. Aortic PWV and AIx were assessed from carotid-femoral segment and radial artery waveforms with the use of the SphygmoCor device. In the crude model, aortic PWV increased significantly with increasing serum hs-CRP levels; PWV increased by 2.48 m/s (95% CI 1.58; 3.38) in the fifth compared to the first quintile of hs-CRP. In the adjusted model, the PWV increased by 0.84 m/s (95% CI 0.13; 1.55) in the fifth quintile compared to the first quintile (P-value was 0.02). In the crude model, AIx increased significantly with increasing serum hs-CRP levels; AIx increased by 7.17% (95% CI 3.72; 10.62) in the fifth versus the first quintile. Adjusted for confounders, AIx remained 4.57% (95% CI 1.32; 7.82) higher in the fifth compared to the first quintile (P-value for trend was o0.01). More adjustment for subclinical atherosclerosis attenuated the b-coefficient for PWV (difference 0.71 m/s (95% CI 0.01; 1.41), but not for AIx (4.60% (95% CI 1.34; 7.85)). In summary, low-grade inflammation seems to be independently related to increase of aortic artery stiffness over and above traditional risk factors and atherosclerosis.

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Clinical Application of C-Reactive Protein for Cardiovascular Disease Detection and Prevention

Cited by 2,179 publications

References 53 publications

Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries

Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries

Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets

C-reactive protein and aortic stiffness and wave reflection in middle-aged and elderly men from the community

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