Hashimoto Hiroyuki, Kitagawa Kazuo, Hougaku Hidetaka, Etani Hideki, Hori Masatsugu
Department of Internal Medicine, Osaka National Hospital 2-1-14, Hoenzaka, Chuo-ku, Osaka, Japan.
Clin Invest Med. 2006 Apr;29(2):77-82.
The Framingham risk score is a popular tool for estimating cardiovascular risk, but there is debate about the value of C-reactive protein. This study investigated the utility of C-reactive protein to predict the progression of atherosclerosis in relation to the Framingham risk score and age.
This observational study enrolled 164 outpatients (mean age: 61 yr; range: 40 - 75 yr) receiving treatment for classical cardiovascular risk factors. They underwent serial ultrasonographic evaluation of their carotid arteries for 36 +/- 10 months. A carotid intima-media thickness > or = 1.1 mm was defined as plaque, and the number of plaques and plaque score (sum of all plaque thicknesses) were determined. Serum C-reactive protein concentrations and classical risk factors, including body mass index, were measured.
C-reactive protein was related to annual changes in the number of plaques and the plaque score (r=0.26 and 0.28; P<0.01 and P<0.001, respectively), as well as the 10-year risk of cardiovascular disease estimated from the Framingham risk score (r=0.335, P<0.001). C-reactive protein was correlated with the annual changes of plaque number and plaque score (beta=0.21 and 0.23; P<0.05 and P<0.01) after adjusting for 10-year cardiovascular and other risk factors, especially in 64 patients comprising the 8-13% 10-year risk group (beta=0.33 for plaque score, P<0.05). CRP also showed a relationship with the progression of carotid atherosclerosis in 71 patients aged < or = 61 yr (beta=0.33 for plaque score, P<0.01).
C-reactive protein can predict the progression of early carotid atherosclerosis in patients with mild to moderate cardiovascular risk and/or middle-aged patients.
弗雷明汉风险评分是一种用于评估心血管疾病风险的常用工具，但对于C反应蛋白的价值存在争议。本研究探讨了C反应蛋白在预测动脉粥样硬化进展方面的作用，及其与弗雷明汉风险评分和年龄的关系。
本观察性研究纳入了164名接受经典心血管危险因素治疗的门诊患者（平均年龄：61岁；范围：40 - 75岁）。他们接受了为期36±10个月的颈动脉超声检查。颈动脉内膜中层厚度≥1.1mm被定义为斑块，并确定斑块数量和斑块评分（所有斑块厚度之和）。测量血清C反应蛋白浓度和包括体重指数在内的经典危险因素。
C反应蛋白与斑块数量和斑块评分的年度变化相关（r = 0.26和0.28；P分别<0.01和P<0.001），也与根据弗雷明汉风险评分估计的10年心血管疾病风险相关（r = 0.335，P<0.001）。在调整了10年心血管疾病及其他危险因素后，C反应蛋白与斑块数量和斑块评分的年度变化相关（β = 0.21和0.23；P<0.05和P<0.01），特别是在64名处于10年风险8 - 13%组的患者中（斑块评分β = 0.33，P<0.05）。C反应蛋白在71名年龄≤61岁的患者中也与颈动脉粥样硬化进展相关（斑块评分β = 0.33，P<0.01）。
C反应蛋白可以预测轻度至中度心血管疾病风险患者和/或中年患者早期颈动脉粥样硬化的进展。
