Abstract 15680: Serum High-Sensitivity C-reactive Protein Levels Throughout Early Adulthood and Subclinical Atherosclerosis in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Introduction: Single measures of high sensitivity C-reactive protein (hs-CRP) have been associated with atherosclerosis. However, trajectories of hs-CRP through young adulthood and their associations with mid-life coronary artery calcification (CAC) are poorly characterized. Methods: We examined longitudinal data from 4681 participants in the CARDIA study, including men and women aged 18-30 years at baseline followed for 25 years. We included participants with >3 hs-CRP measurements and a CAC score measured at year 25. We also examined cardiovascular (CV) risk factor trajectories through young adulthood in parallel with hs-CRP. Multivariable logistic regression models were used to assess association between hs-CRP trajectories and CAC >0 status at year 25. Results: We identified 5 discrete trajectories in hs-CRP from young adulthood to middle age according to measured hs-CRP levels and time course: low-stable (56%, n=1364), low-early rise (18%, n=432), low-late rise (7%, n=155), elevated-stable (6%, n=136), and elevated-decline (13%, n=308) (Figure 1). Compared with the low-stable group, trajectories with early, but not later elevations of hs-CRP levels had significantly higher odds of CAC score > 0 at year 25. Odds ratios (OR; adjusted for age, sex, race and education) were 1.71 (95% CI, 1.11-2.64) for the elevated-stable group and 1.98 (1.49-2.65) for elevated-decline group. After adjustment for all CV risk factors, only the elevated-decline group retained significance (OR 1.46, 1.06-2.02). Trajectories of CV risk factors, especially BMI, through young adulthood were highly correlated with hs-CRP trajectories, and attenuated associations of hs-CRP with CAC. Conclusions: Trajectories with early elevations in hs-CRP in young adulthood are associated with mid-life CAC. CV risk factor trajectories correlate with hs-CRP over time, suggesting that hs-CRP trajectory may integrate data from other risk factors and provide information about CAC risk.