Objective To evaluate the association between vascular inflammation as measured by sub-acute C-reactive protein (CRP; 1 - 10mg/L) and all-cause mortality and the association between change in change in CRP status (normal, ≤3mg/L and elevated >3mg/L) and all-cause mortality.
Methods Probabilistic record linkage was used to match hospital episode data, laboratory reports and mortality statistics in a large urban population. Survival was evaluated using Cox proportional hazards regression models (CPHM).
Results 22,982 cases had their first CRP measurement in the sub-acute range (1 - 10mg/L). Analysis grouped by each additional unit increase in CRP across the sub-acute range was associated with a 7.3% increase in the hazard ratio (HR) of death over four years, after controlling for confounding factors (p < 0.001). Repeated CRP observations around one year apart were recorded in 5,811 subjects. After controlling for confounding factors, in cases whose CRP changed from normal (≤ 3 mg/L) to elevated (> 3 mg/L), the HR increased 6.7 fold (p < 0.001) relative to cases whose CRP remained normal. By comparison, among those subjects whose CRP was reduced from elevated to normal, the hazard ratio halved to 3.5 (p = 0.018). In an underpowered analysis of time to cardiovascular events, an identical pattern of risk emerged.
Conclusions CRP level predicted all-cause mortality and additional inclusion of prior change in CRP level and current CRP level more so. Increasing vascular inflammation, as measured by CRP, increases the likelihood of death.
- C-reactive protein
- acute myocardial infarction
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.