Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Department of Cardiology, Kailuan Hospital, Tangshan, People's Republic of China.
Clin Chem. 2017 Mar;63(3):663-672. doi: 10.1373/clinchem.2016.260828. Epub 2016 Dec 28.
Most previous studies regarding chronic inflammation and risk of myocardial infarction (MI) have lacked repeated measures of high-sensitivity C-reactive protein (hs-CRP) and/or white blood cell (WBC) count over time. We examined whether cumulative average and longitudinal changes in these biomarkers were associated with subsequent MI risk.
In this prospective, community-based study, we included 82544 Chinese participants [66796 men and 15748 women; mean (SD) age 55.1 (9.86) y] without prior cardiovascular diseases or cancer at baseline (2006-2007). hs-CRP, WBC and other clinical covariates were assessed at baseline and every 2 years during follow-up.
During 6 years of follow-up (2006-2012), we documented 714 incident MI cases. Higher baseline and cumulative average concentrations of hs-CRP and/or WBC were consistently associated with increased risk of MI ( <0.001 for both). Longitudinal increase in hs-CRP ( <0.001), but not WBC, was also associated with a higher future risk of MI, after adjustment for their baseline values and other covariates. Each 1-mg/L increment per year in hs-CRP was associated with a 9.3% increase in risk for future MI [hazard ratio (HR) = 1.09, 95% CI, 1.03; 1.17]. Participants with high-grade inflammatory status (hs-CRP ≥10 mg/L and WBC ≥10 × 10/L) had a higher risk of MI occurring <3 months after hs-CRP/WBC assessments vs those with hs-CRP <0.5 mg/L and WBC <5 × 10/L (HR = 6.64; 95% CI, 1.49-29.6), as compared with MI occurring ≥4 years (HR = 2.95; 95% CI, 0.90, 9.65).
Plasma hs-CRP concentration and WBC predicted MI risk. Longitudinal increase in hs-CRP was also associated with a higher risk of MI.
大多数先前关于慢性炎症与心肌梗死 (MI) 风险的研究缺乏对高敏 C 反应蛋白 (hs-CRP) 和/或白细胞 (WBC) 计数随时间的重复测量。我们研究了这些生物标志物的累积平均值和纵向变化是否与随后的 MI 风险相关。
在这项前瞻性、基于社区的研究中，我们纳入了 82544 名中国参与者[66796 名男性和 15748 名女性；平均（SD）年龄 55.1（9.86）岁]，基线时无心血管疾病或癌症。hs-CRP、WBC 和其他临床协变量在基线和随访期间每 2 年进行一次评估。
在 6 年的随访期间（2006-2012 年），我们记录了 714 例 MI 事件。较高的基线和累积平均 hs-CRP 和/或 WBC 浓度与 MI 风险增加相关（均<0.001）。调整基线值和其他协变量后，hs-CRP 的纵向升高（<0.001）也与 MI 的未来风险增加相关，而 WBC 的纵向升高则不然。每年每增加 1mg/L hs-CRP，未来 MI 的风险增加 9.3%[风险比（HR）=1.09，95%置信区间（CI）为 1.03；1.17]。与 hs-CRP <0.5mg/L 和 WBC <5×10/L 的参与者相比，hs-CRP/WBC 评估后 3 个月内发生炎症程度较高（hs-CRP≥10mg/L 和 WBC≥10×10/L）的参与者发生 MI 的风险更高（HR=6.64；95%CI，1.49-29.6），而发生 MI 的时间≥4 年（HR=2.95；95%CI，0.90，9.65）。
血浆 hs-CRP 浓度和 WBC 预测 MI 风险。hs-CRP 的纵向升高也与 MI 风险增加相关。
