Early elevation of high-sensitivity C-reactive protein as a predictor for cardiovascular disease incidence and all-cause mortality: a landmark analysis

Abstract

We investigated the association between early elevation of high-sensitivity C-reactive protein (hsCRP) and cardiovascular disease (CVD) incidence, all-cause mortality, and CVD mortality. We analyzed 6567 participants from the Korean Genome and Epidemiology Study_Ansan_Ansung cohort between 2005 and 2018. The Kaplan–Meier curves and modified Cox regression by Fine and Gray were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD incidence, all-cause mortality, CVD mortality, cancer mortality, and mortality from other causes. Landmark analyses were performed at the first (2007–2008) and second (2009–2010) follow-up periods, with early elevation defined as hsCRP > 2 mg/L. At the first and second landmark points, the early hsCRP elevation group had a higher incidence of CVD and all-cause mortality. At first landmark point, the adjusted HRs (95% CIs) were 1.37 (1.08–1.74) for incident CVD and 1.26 (1.04–1.53) for all-cause mortality, respectively. At second landmark point, the adjusted HRs in the early hsCRP elevation group were 1.45 (1.12–1.89) for incident CVD and 1.34 (1.10–1.63) for all-cause mortality, respectively. However, there were no significant differences in CVD mortality and cancer mortality between the groups. In conclusion, early elevation of serum hsCRP is a predictor of incident CVD and all-cause mortality. The timing of hsCRP increase is also a significant predictor of incident CVD, even considering the competing risk. Regular hsCRP testing may help monitor hsCRP trends and develop individualized treatment plans for CVD prevention.

Association between augmented levels of the gut pro-hormone Proneurotensin and subclinical vascular damage

“…Chronic subclinical inflammation is another potential factor implicated in the association between higher proNT levels and cardiovascular organ damage. In line with prior studies showing the pro-inflammatory properties of NT, we observed that subjects with higher proNT levels displayed increased levels of the pro-inflammatory marker hsCRP, a broadly recognized predictor of CVDs 48 . However, we found that the association between higher levels of proNT and vascular damage was independent of hsCRP values, but given the complexity and redundancy of inflammatory pathways involved in the development of atherosclerosis 49 , the role of other pro-inflammatory factors in mediating the negative effect of proNT on vascular biology may not be firmly excluded.…”

Effects of short-term restriction of animal products on blood biomarkers and cardiovascular disease risk

“…Furthermore, most blood biomarkers measured are known to capture relatively acute dietary effects, meaning that with the present measurements we are underpowered to detect likely long-term effects of periodic restriction of animal products on markers of human health. Another limitation of our study is that we report on levels of inflammation through quantification of CRP levels instead of high-sensitivity CRP (hs-CRP), which is more commonly used to detect the risk for inflammatory conditions 35 . Finally, although we have adjusted for confounding factors to the best of our ability, some residual effects may persist in reported results.…”