Title | Six-year change in high-sensitivity C-reactive protein and risk of diabetes, cardiovascular disease, and mortality. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Parrinello CM, Lutsey PL, Ballantyne CM, Folsom AR, Pankow JS |
Secondary Authors | Selvin E |
Journal | Am Heart J |
Volume | 170 |
Issue | 2 |
Pagination | 380-9 |
Date Published | 2015 Aug |
ISSN | 1097-6744 |
Keywords | Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Cause of Death, Comorbidity, Diabetes Mellitus, Disease Progression, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Nephelometry and Turbidimetry, Prognosis, Risk Assessment, Risk Factors, Survival Rate, Time Factors, United States |
Abstract | BACKGROUND: Single measurements of elevated high-sensitivity C-reactive protein (hs-CRP) are associated with increased risk of diabetes, cardiovascular disease, and mortality. Large increases or sustained elevations in hs-CRP may be associated with even greater risk of these outcomes. The objective of this study was to characterize the association of 6-year change in hs-CRP with incident diabetes, incident cardiovascular events (heart disease, stroke, and heart failure), and mortality. METHODS: We included 10,160 ARIC participants with hs-CRP measured at visits 2 (1990-1992) and 4 (1996-1998). Change in hs-CRP was categorized as sustained low/moderate ( RESULTS: Compared with persons with sustained low/moderate hs-CRP, those with increased or sustained elevated hs-CRP had an increased risk of incident diabetes (hazard ratios [95% CIs] 1.56 [1.38-1.76] and 1.39 [1.25-1.56], respectively), whereas those with deceased hs-CRP did not. Persons with sustained elevated hs-CRP had an increased risk of coronary heart disease, ischemic stroke, heart failure, and mortality (hazard ratios [95% CIs] 1.51 [1.23-1.85], 1.70 [1.32-2.20], 1.60 [1.35-1.89], and 1.52 [1.37-1.69], respectively) compared with those with sustained low/moderate hs-CRP. Associations for sustained elevated hs-CRP were greater than for those with increased hs-CRP over 6 years. CONCLUSIONS: Large increases or sustained elevations in hs-CRP over a 6-year period were associated with a subsequent increased risk of diabetes, and persons with sustained elevations in hs-CRP were at the highest risk for cardiovascular disease and mortality. Two measurements of hs-CRP are better than one for characterizing risk, and large increases are particularly prognostic. |
DOI | 10.1016/j.ahj.2015.04.017 |
Alternate Journal | Am Heart J |
PubMed ID | 26299237 |
PubMed Central ID | PMC4548857 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100009I / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States HHSN268201100005C / / PHS HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100009C / / PHS HHS / United States R01DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100011I / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States T32 HL007024 / HL / NHLBI NIH HHS / United States HHSN268201100010C / / PHS HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States HHSN268201100008C / / PHS HHS / United States HHSN268201100012C / / PHS HHS / United States HHSN268201100005I / HL / NHLBI NIH HHS / United States T32HL007024 / HL / NHLBI NIH HHS / United States HHSN268201100007C / / PHS HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100011C / / PHS HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States HHSN268201100007I / HL / NHLBI NIH HHS / United States HHSN268201100006C / / PHS HHS / United States |