Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR.
Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, IR.
Glob Heart. 2020 Feb 6;15(1):3. doi: 10.5334/gh.367.
High sensitivity C-reactive protein (hs-CRP) was proven to be an independent risk factor for cardiovascular diseases (CVDs). The aim of this study was to investigate the benefits of assessing hs-CRP among individuals with different cardiovascular risk factors.
This nested case-control study was obtained from the Isfahan Cohort Study (ICS). Anyone who has been suffering from any CVDs, including myocardial infarction, unstable angina, sudden cardiac death and stroke was put in the case group. Density sampling method was utilized to choose the control group who had no aforementioned CVDs during follow-up. Four quartiles of hs-CRP (Q1: 0.1-2.3, Q2: 2.4-3, Q3: 3.1-4 and Q4: 4.1-14 mg/l) were assessed defining odds ratios (OR) of CVDs prediction in different CVDs risk factor categories. Confidence intervals of 95% are put in brackets.
A total of 502 cases and 538 controls were recruited. All hs-CRP quartiles showed increased CVDs likelihood compared to normal subjects in terms of diabetes mellitus (DM) and hypertension (HTN). Second quartile showed a 1.93 [1.33-2.81] and 3.34 [1.36-8.17] increased risks in patients with hypertriglyceridemia or dyslipidemia, respectively. Smokers in the third quartile group revealed increased CVDs risk. The fourth quartile showed significant increased risks in patients suffering from hypercholesterolemia (OR = 1.91 [1.33-2.74]), high LDL-C (OR = 1.88 [1.33-2.66]), and hypertriglyceridemia (OR = 2.31 [1.57-3.41]).
Our findings suggested that assessing hs-CRP is beneficial for predicting CVDs in patients with HTN and DM. Furthermore, specific patients with lipid abnormalities or history of smoking benefits from checking hs-CRP.
高敏 C 反应蛋白（hs-CRP）已被证实是心血管疾病（CVDs）的独立危险因素。本研究旨在探讨在具有不同心血管危险因素的个体中评估 hs-CRP 的获益。
本巢式病例对照研究来源于伊斯法罕队列研究（ICS）。任何患有 CVDs 的人，包括心肌梗死、不稳定型心绞痛、心源性猝死和中风，都被归入病例组。采用密度抽样法选择随访期间无上述 CVDs 的对照组。评估 hs-CRP 的四个四分位数（Q1：0.1-2.3、Q2：2.4-3、Q3：3.1-4 和 Q4：4.1-14mg/L），以评估不同 CVDs 危险因素类别中 CVDs 预测的比值比（OR）。置信区间为 95%。
共纳入 502 例病例和 538 例对照。所有 hs-CRP 四分位组与正常人群相比，糖尿病（DM）和高血压（HTN）患者的 CVDs 可能性均增加。第二四分位组中，高三酰甘油血症或血脂异常患者的风险分别增加 1.93[1.33-2.81]和 3.34[1.36-8.17]。第三四分位组的吸烟者 CVDs 风险增加。第四四分位组显示出患有高胆固醇血症（OR=1.91[1.33-2.74]）、高 LDL-C（OR=1.88[1.33-2.66]）和高三酰甘油血症（OR=2.31[1.57-3.41]）的患者风险显著增加。
我们的研究结果表明，评估 hs-CRP 有利于预测 HTN 和 DM 患者的 CVDs。此外，具有血脂异常或吸烟史的特定患者从检查 hs-CRP 中获益。
