Lowe G D O, Sweetnam P M, Yarnell J W G, Rumley A, Rumley C, Bainton D, Ben-Shlomo Y
Department of Medicine, University of Glasgow, Scotland, UK.
Arterioscler Thromb Vasc Biol. 2004 Oct;24(10):1957-62. doi: 10.1161/01.ATV.0000141842.27810.a9. Epub 2004 Aug 12.
There is increasing interest in the predictive value of C-reactive protein (CRP) and fibrin D-dimer in the prediction of ischemic heart disease (IHD). We assessed their joint and independent associations with IHD in a large combined analysis of 2 population cohorts.
Men aged 49 to 66 years from the general populations of Caerphilly and Speedwell were studied between 1982 and 1988 and re-examined for new IHD events at fixed intervals of approximately 105 months (Caerphilly) and 75 months (Speedwell). 3213 men had CRP and D-dimer measured at baseline and 351 (11%) had a new IHD event. Mean levels of CRP and D-dimer were significantly higher among men in whom IHD developed. The relative odds of IHD in men in the top 20% of the distribution of CRP was 2.97 (95% CI, 2.04, 4.32) and for D-dimer was 2.40 (95% CI, 1.69, 3.40); CRP and D-dimer had additive effects on risk of IHD. Multivariate analysis reduced the size of the relative odds, which remained significant for D-dimer.
Both inflammatory and thrombogenic markers are important (and potentially additive) predictors of coronary risk.
C反应蛋白（CRP）和纤维蛋白D - 二聚体在预测缺血性心脏病（IHD）方面的预测价值越来越受到关注。我们在对2个人群队列的大型联合分析中评估了它们与IHD的联合及独立关联。
1982年至1988年期间，对来自卡菲利和斯皮德韦尔普通人群中49至66岁的男性进行了研究，并以大约105个月（卡菲利）和75个月（斯皮德韦尔）的固定间隔重新检查新的IHD事件。3213名男性在基线时测量了CRP和D - 二聚体，其中351名（11%）发生了新的IHD事件。发生IHD的男性中CRP和D - 二聚体的平均水平显著更高。CRP分布前20%的男性发生IHD的相对比值为2.97（95%CI，2.04，4.32），D - 二聚体为2.40（95%CI，1.69，3.40）；CRP和D - 二聚体对IHD风险有相加作用。多变量分析降低了相对比值的大小，D - 二聚体仍具有显著意义。
炎症和血栓形成标志物都是冠状动脉风险的重要（且可能具有相加作用）预测指标。
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