Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events
- PMID: 12432042
- DOI: V体育安卓版 - 10.1056/NEJMoa021993
Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events
Abstract (V体育2025版)
Background: Both C-reactive protein and low-density lipoprotein (LDL) cholesterol levels are elevated in persons at risk for cardiovascular events VSports手机版. However, population-based data directly comparing these two biologic markers are not available. .
Methods: C-reactive protein and LDL cholesterol were measured at base line in 27,939 apparently healthy American women, who were then followed for a mean of eight years for the occurrence of myocardial infarction, ischemic stroke, coronary revascularization, or death from cardiovascular causes V体育安卓版. We assessed the value of these two measurements in predicting the risk of cardiovascular events in the study population. .
Results: Although C-reactive protein and LDL cholesterol were minimally correlated (r=0. 08), base-line levels of each had a strong linear relation with the incidence of cardiovascular events. After adjustment for age, smoking status, the presence or absence of diabetes mellitus, categorical levels of blood pressure, and use or nonuse of hormone-replacement therapy, the relative risks of first cardiovascular events according to increasing quintiles of C-reactive protein, as compared with the women in the lowest quintile, were 1 V体育ios版. 4, 1. 6, 2. 0, and 2. 3 (P<0. 001), whereas the corresponding relative risks in increasing quintiles of LDL cholesterol, as compared with the lowest, were 0. 9, 1. 1, 1. 3, and 1. 5 (P<0. 001). Similar effects were observed in separate analyses of each component of the composite end point and among users and nonusers of hormone-replacement therapy. Overall, 77 percent of all events occurred among women with LDL cholesterol levels below 160 mg per deciliter (4. 14 mmol per liter), and 46 percent occurred among those with LDL cholesterol levels below 130 mg per deciliter (3. 36 mmol per liter). By contrast, because C-reactive protein and LDL cholesterol measurements tended to identify different high-risk groups, screening for both biologic markers provided better prognostic information than screening for either alone. Independent effects were also observed for C-reactive protein in analyses adjusted for all components of the Framingham risk score. .
Conclusions: These data suggest that the C-reactive protein level is a stronger predictor of cardiovascular events than the LDL cholesterol level and that it adds prognostic information to that conveyed by the Framingham risk score. VSports最新版本.
Copyright 2002 Massachusetts Medical Society
Comment in
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VSports手机版 - C-reactive protein--to screen or not to screen?N Engl J Med. 2002 Nov 14;347(20):1615-7. doi: 10.1056/NEJMe020127. N Engl J Med. 2002. PMID: 12432050 No abstract available.
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"VSports注册入口" C-reactive protein in the prediction of cardiovascular events.N Engl J Med. 2003 Mar 13;348(11):1059-61; author reply 1059-61. doi: 10.1056/NEJM200303133481115. N Engl J Med. 2003. PMID: 12637619 No abstract available.
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C-reactive protein in the prediction of cardiovascular events. (VSports在线直播)N Engl J Med. 2003 Mar 13;348(11):1059-61; author reply 1059-61. N Engl J Med. 2003. PMID: 12638579 No abstract available.
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C-reactive protein in the prediction of cardiovascular events.N Engl J Med. 2003 Mar 13;348(11):1059-61; author reply 1059-61. N Engl J Med. 2003. PMID: 12638580 No abstract available.
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Inflammation in atherosclerosis, not yet time for a paradigm shift?Curr Opin Lipidol. 2003 Jun;14(3):325-8. doi: 10.1097/00041433-200306000-00012. Curr Opin Lipidol. 2003. PMID: 12840662 No abstract available.
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The relationship between inflammation and atherosclerotic events.Rev Cardiovasc Med. 2004 Winter;5(1):66-8. Rev Cardiovasc Med. 2004. PMID: 15085794 No abstract available.
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