Use Of High-sensitivity C-reactive Protein Research Articles

Associations of dietary vitamin A and C intake with asthma, allergic rhinitis, and allergic respiratory diseases.

Asthma and allergic rhinitis (AR) are closely related and considered as allergic respiratory diseases (ARD), and their prevalence has recently increased. Data on the association of dietary antioxidant vitamin intake with asthma and AR in adults are limited. The present study aimed to investigate the associations of vitamin A and C intake with asthma, AR, and all cases of both diseases in young adults who participated in a cross-sectional national survey, with the use of high-sensitivity C-reactive protein (hs-CRP) level as an effect modifier. This study included 6,293 male and female adults aged 20-49 years from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2016 and 2018. The questionnaire-based reports on asthma and AR diagnosis were used to determine outcome variables. Further, 24-h recall data on dietary vitamin A and C, carotene, and retinol intake were acquired. Logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence interval (CI). Dietary vitamin C intake was inversely associated with asthma prevalence among participants with hs-CRP levels (≥ 1 mg/L); the OR of asthma prevalence was 0.27 (95% CI, 0.08-0.84) for participants with vitamin C consumption ≥ 75 mg/day compared with those consuming < 20 mg/day. Similar association analyses limiting to non-users of dietary supplements were performed to rule out the potential effects of supplement intake on the outcomes; results showed a stronger association. However, the association between vitamin C and asthma was not significant in participants with hs-CRP levels < 1 mg/L; the OR of asthma was 1.44 (95% CI, 0.66-3.16) for participants with vitamin C consumption ≥ 75 mg/day compared with those consuming < 20 mg/day. Vitamin C intake was not associated with AR. Moreover, there was no association between vitamin A intake and neither asthma nor AR. These findings suggest that higher vitamin C intake may play a potential role in reducing asthma prevalence. Nevertheless, further studies should be conducted to evaluate whether this association is causal.

HIGH SENSITIVITY- C REACTIVE PROTEIN AS CARDIOVASCULAR RISK MARKER IN METABOLIC SYNDROME PATIENTS.

Background &amp; Objectives: 20-25% of the world's adult population have metabolic syndrome (MetS); mortality of these people is double, and the morbidity of heart attack or stroke is three times higher than in the healthy population. Recent research has focused on the use of high-sensitivity C-reactive protein (hs-CRP), a marker of inammation, in the detection of patients at increased risk for cardiovascular disease. The study was conducted to evaluate for the evidence of the association between baseline hs-CRP levels and the metabolic syndrome. Methods: It was a cross-sectional study of 200 adults, 18–50 years of age, both the sexes randomly selected from diabetes &amp; obesity OPD at tertiary care hospital &amp; compared with 200 age &amp; sex-matched controls. Diagnosis of Metabolic syndrome was done according to Modied National Cholesterol Education Program ATP III criteria (2004). High Sensitivity -C Reactive Proteins -hs-CRP was done by ELISA method (CAL BIOTECH). Statistical Analysis was done by Pearson correlation coefcient to study the correlation between hs-CRP &amp; various components of metabolic syndrome. Results: We found signicantly increased hs-CRP levels (P&lt;0.001) in metabolic syndrome, 60% of patients with metabolic syndrome belonged to the high-risk group with a mean hs-CRP value &gt;3 mg/L &amp; a positive correlation of hs-CRP with abdominal circumference &amp; triglyceride &amp; HDL levels Conclusion: increased hs- CRP levels in metabolic syndrome may increase the risk of having cardiovascular mortality. These prospective data suggest that measurement of hs-CRP adds clinically important prognostic information to the metabolic syndrome.

Association between Hs-CRP and other Cardiovascular Risk Factors with Blood Pressure in Young Adults

INTRODUCTION: Hypertension remains the leading preventable risk factor for premature mortality and morbidity worldwide. The use of high-sensitivity C-reactive protein (hs-CRP) as the global risk prediction assessment for cardiovascular diseases (CVD) in asymptomatic individuals suggests the possibility that higher hs-CRP, or subclinical inflammation, maybe one of the causal factors contributing to an increased risk of CVD in young hypertensive patients. Most studies of hypertension and hs-CRP association were conducted regionally, whereby most of the participants were Caucasians with age beyond 40 years old. Studies of this association among young adults in Asian populations are lacking, therefore, a generalization of data might be limited to certain ages and populations only. MATERIALS AND METHOD: This comparative cross-sectional study analysed the association between hs-CRP and other cardiovascular risk factors with three different blood pressure statuses categorised into Normotensive (NT), Pre-hypertensive (PHT), and Hypertensive (HPT) groups among young adults in Kuantan, Pahang, Malaysia. RESULTS: Independently, the association was significant only in males and subjects with parental history of hypertension in the prehypertensive group. However, in the hypertensive group, the relationships were significant not only in males and individuals with parental histories of hypertension but also in obese subjects. Hs[1]CRP was not associated with blood pressure status in the present study. CONCLUSION: The hypothesis that hs[1]CRP has an independent association with blood pressure status was not demonstrated in the present study. However, the observed association between circulating hs-CRP and blood pressure status is likely to be driven by confounders namely age, gender, genetic factors, and BMI status.

Association of high-sensitivity C-reactive protein and long-term mortality may differ from lipoprotein(a) levels among patients undergoing coronary angiography

Abstract Background The use of high-sensitivity C-reactive protein (hs-CRP) as an inflammation biomarker in predicting long-term mortality remains controversial. We aimed to investigate whether the association of hs-CRP with long-term mortality differs from another inflammation biomarker, lipoprotein(a), in patients undergoing coronary angiography (CAG). Methods A total of 2422 patients undergoing CAG were included in the final analysis from a prospective, observational study. We divided them into 4 groups according to hs-CRP level (high ≥4.8 mg/l, low &amp;lt;4.8 mg/l) and lipoprotein(a) level (high ≥17 mg/dl, low &amp;lt;17 mg/dl). Results The overall incidence of all-cause long-term mortality was 133/2422 (5.5%). In the high lipoprotein(a) group, after adjusting for LDL-cholesterol concentration (LDL-C), age, sex, smoking status, diabetes mellitus and estimated glomerular filtration rate (eGFR), a high hs-CRP level was an independent predictor of all-cause long-term mortality (hazard ratio: 2.01; 95% CI: 1.13–3.54; p=0.02). In the low lipoprotein(a) group, a similar result was not found (hazard ratio: 1.42; 95% CI: 0.92–2.01; p=0.24). Conclusions Our data suggested that the association of hs-CRP with all-cause long-term mortality may differ from lipoprotein(a) levels among patients undergoing CAG. In addition to hs-CRP, a high lipoprotein(a) level might be a simultaneous intervention target for improving long-term prognosis in the future. Funding Acknowledgement Type of funding source: None

Targeting cardiovascular inflammation: next steps in clinical translation.

Systemic vascular inflammation plays multiple maladaptive roles which contribute to the progression and destabilization of atherosclerotic cardiovascular disease (ASCVD). These roles include: (i) driving atheroprogression in the clinically stable phase of disease; (ii) inciting atheroma destabilization and precipitating acute coronary syndromes (ACS); and (iii) responding to cardiomyocyte necrosis in myocardial infarction (MI). Despite an evolving understanding of these biologic processes, successful clinical translation into effective therapies has proven challenging. Realizing the promise of targeting inflammation in the prevention and treatment of ASCVD will likely require more individualized approaches, as the degree of inflammation differs among cardiovascular patients. A large body of evidence has accumulated supporting the use of high-sensitivity C-reactive protein (hsCRP) as a clinical measure of inflammation. Appreciating the mechanistic diversity of ACS triggers and the kinetics of hsCRP in MI may resolve purported inconsistencies from prior observational studies. Future clinical trial designs incorporating hsCRP may hold promise to enable individualized approaches. The aim of this Clinical Review is to summarize the current understanding of how inflammation contributes to ASCVD progression, destabilization, and adverse clinical outcomes. We offer forward-looking perspective on what next steps may enable successful clinical translation into effective therapeutic approaches-enabling targeting the right patients with the right therapy at the right time-on the road to more individualized ASCVD care.

High-Sensitivity C-Reactive Protein: A Potential Ancillary Biomarker for Malaria Diagnosis and Morbidity.

Background Malaria remains an important cause of morbidity and mortality in Africa. Previous studies that assessed C-reactive protein (CRP) have centered on the conventional method. This study evaluated the usefulness of high-sensitivity CRP (hs-CRP) in malaria diagnosis and morbidity in a pediatric population in Ghana. Methodology A total of 267 subjects (100 microscopically proven nonmalarial parasitaemics as controls and 167 plasmodium parasitaemic subjects as cases), between the ages of 7 months and 18 years, were recruited for this case-control study. Blood samples were collected for malaria parasite density by microscopic examination; full blood count, electrolytes, and liver function tests using an automated analyzer; and hs-CRP levels by sandwich ELISA method. Results The median hs-CRP concentration was lowest in the control group and increased significantly from low to high parasitaemia. The median hs-CRP level was significantly higher in high malaria parasitaemia compared to moderate and low malaria parasitaemia. Increasing hs-CRP cutoff (3.12-4.64 mg/L) presented with increasing specificity (79.3-93.1%) and sensitivity (96.4%-97.4%), except for moderate parasitaemia where a decline in sensitivity (80.9%) was observed. However, hs-CRP had relatively lower PPV but high NPV at low parasitaemia while both the PPV and NPV were moderate in moderate parasitaemia. Conclusion hs-CRP yielded a high sensitivity, specificity, and accuracy for low, moderate, and high-grade malaria, respectively, and thus may serve as an effective supplementary diagnostic and prognostic biomarker for Plasmodium parasite infection. However, hs-CRP might not be readily useful yet for diagnostic purposes in hospitals due to the relatively low PPV and NPV for low and moderate parasitaemia and thus necessitates further studies in larger cohorts.

Incremental prognostic value of high-sensitive C-reactive protein in patients undergoing coronary computed tomography angiography

BackgroundThis study was performed to investigate whether combined use of high-sensitivity C-reactive protein (hs-CRP) levels and coronary computed tomography angiography (CCTA) results have additional prognostic value for predicting cardiovascular events in patients with suspected coronary artery disease (CAD). MethodsA total of 445 patients (61.6±9.3 years and 62.9% men) with suspected CAD who underwent both CCTA and hs-CRP measurement within one month were evaluated. Information on cardiovascular events, including cardiac death, non-fatal myocardial infarction, unstable angina and late (≥six months after CCTA) coronary revascularization was assessed. ResultsOne hundred and eighty-five patients (41.6%) had obstructive CAD on CCTA (stenosis ≥50%). Both high hs-CRP (≥2.25mg/L) and obstructive CAD were the independent predictors of cardiovascular events. Kaplan–Meier analysis showed that event rates were significantly different according to the presence of obstructive CAD and hs-CRP levels. Addition of hs-CRP levels to combined information of clinical factors and CCTA results further increased the predictive power for cardiovascular events (global chi-square ratio, from 13.51 to 19.14, p=0.022). Event risks were approximately 21.0-fold higher in the highest-risk group with both obstructive CAD and high hs-CRP levels than in the lowest-risk group with both insignificant CAD and low hs-CRP levels (p=0.007). ConclusionsCombined use of hs-CRP levels and CCTA results provided a significant improvement in prognostic power for cardiovascular events in patients with suspected CAD. hs-CRP measurement may be a simple and useful method for determining risk stratification and treatment strategy in patients undergoing CCTA.

Combined Use of High-sensitivity C-Reactive Protein and N-Terminal Pro-B-type Natriuretic Peptide for Risk Stratification of Vascular Surgery Patients

We sought to assess whether high-sensitivity C-reactive protein (hs-CRP) and pro-B-type natriuretic peptide (NT-proBNP) improve risk prediction when added to an established predictive tool and develop a point-based risk score. Four hundred eleven vascular surgery patients were enrolled. The primary outcome was a composite of death, acute coronary syndromes, pulmonary edema within 30 days of surgery, and postoperative troponin-I elevation. The risk score was developed from a logistic regression model by using an integer-based scoring system. The rate of the primary outcome was 18%. Adding both hs-CRP and NT-proBNP to the Revised Cardiac Risk Index led to an increase in C statistic from 0.670 to 0.774. The net reclassification improvement was 0.210 (P = 0.004) and the integrated discrimination improvement was 0.112 (P = 0.0001). In the multivariable regression analysis used to develop the risk score, insulin therapy for diabetes (odds ratio [OR]: 2.8; P = 0.003), open surgery (OR: 1.95; P = 0.027), fibrinogen >377 mg/dL (OR: 2.83; P = 0.001), hs-CRP >3.2 mg/L (OR: 3.85; P < 0.0001), and NT-proBNP >221 ng/L (OR: 4.05; P < 0.0001) were associated with the primary outcome. There was no statistical evidence of overfit. The C index was 0.82 and the Hosmer-Lemeshow statistic was 1.61 (P = 0.0447). The observed and predicted rates of the primary outcome across quartiles of risk score were highly correlated. Hs-CRP and NT-proBNP substantially improve risk prediction when added to an established predictive tool. The biochemical marker-based risk score may be useful for accurately risk-stratifying vascular surgery patients; nonetheless, further validation studies on external datasets are needed before it can be used in clinical practice.

The conundrum of C-reactive protein as a risk marker for cardiovascular risk assessment: insight from EPIC-Norfolk and JUPITER

This editorial refers to ‘Clinical implications of JUPITER in a contemporary European population: the EPIC-Norfolk prospective population study’[†][1], by B.M. Sondermeijer et al. , on page 1350 The challenge presented by the need to identify individuals with moderate cardiovascular risk who go on to undergo a clinical event remains a topic of intense debate. Subjects in this group present a SCORE of 1–5% at 10 years, and are typified by middle-aged men and women, an ever-expanding group as demographic patterns change worldwide. It is therefore of considerable relevance that criteria for risk assessment in this group in the recent Joint ESC/EAS Guideline recommendations for management of dyslipidaemia not only feature a lower target for LDL-cholesterol (LDL-C; 115 mg/dL), but also emphasize the critical need for estimation of the total cardiovascular risk profile.1 Such an approach to risk evaluation in primary prevention must now, however, integrate the concept of lifetime risk burden, which has the distinct advantage of integrating cumulative risk exposure as compared with a ‘point’ estimate at any given moment over a lifetime.2 A further dimension of risk assessment to enhance predictive power in this group concerns the potential use of circulating biomarkers of inflammation, either alone or in a multimarker panel. Use of high-sensitivity C-reactive protein, which, amongst other biomarkers, is associated with cardiovascular risk, has been prominent in such analyses.3 In this issue of the journal,4 and in continuity with their … [1]: #fn-2

Is High-Sensitivity C-Reactive Protein Associated with Lower Urinary Tract Symptoms in Aging Men? Results from the Hallym Aging Study

PurposeThe pathogenesis of lower urinary tract symptoms (LUTS) is uncertain. We investigated the potential role of inflammation in the development of LUTS, with the use of high-sensitivity C-reactive protein (hsCRP) as an inflammatory marker, in a population-based study of aging men in Korea.Materials and MethodsOur study used a multistage stratified design to recruit a random sample of 1,510 men aged 45 years or older in Chuncheon, Korea, in 2003. Men with urologic or neurologic diseases that could cause voiding dysfunction were excluded. Also, men with medical conditions that could affect inflammation, such as infection or the use of nonsteroidal anti-inflammatory drugs, were excluded. LUTS were defined according to the International Prostate Symptom Score (IPSS). Various potential confounding factors were included in the analyses.ResultsA total of 330 subjects were included in the final analyses. There were 155 (47.0%) with an IPSS<8 and 175 (53%) with an IPSS≥8. The mean age of all subjects was 69.2±8.4 years. The mean hsCRP level of all subjects was 2.30±3.27 (median, 1.19) mg/l. The hsCRP levels in subjects with an IPSS≥8 differed significantly from those in subjects with an IPSS<8. Also, IPSS, storage symptom, voiding symptom, and quality of life (QoL) scores increased as hsCRP levels increased, respectively. The hsCRP level remained an independent risk factor of LUTS (IPSS≥8, storage symptom score≥4, incomplete voiding, intermittency, and QoL) after adjustment for variable possible confounding factors.ConclusionsOur results suggest that inflammatory processes may play an important role in the pathogenesis of LUTS and that hsCRP levels may indicate the severity of LUTS in aging men.

Usefulness of High-Sensitivity C-Reactive Protein to Predict Mortality in Patients With Atrial Fibrillation (from the Atherosclerosis Risk In Communities [ARIC] Study)

High-sensitivity C-reactive protein (hs-CRP) is a marker for the risk of cardiovascular and overall mortality. However, information about the association between hs-CRP and mortality in patients with atrial fibrillation is scarce. A total of 293 participants of the Atherosclerosis Risk In Communities study with a history of AF and hs-CRP levels available were studied. During a median follow-up of 9.4 years, 134 participants died (46%). The hazard ratio of all-cause mortality associated with the highest versus the lowest tertile of hs-CRP was 2.52 (95% confidence interval 1.49 to 4.25) after adjusting for age, gender, history of cardiovascular diseases, and cardiovascular risk factors. A similar trend was observed for cardiovascular mortality (57 events; hazard ratio 1.90, 95% confidence interval 0.81 to 4.45). The Congestive heart failure, Hypertension, Age >75 years, Diabetes, and previous Stroke or transient ischemic attack (CHADS2) score was also associated with all-cause and cardiovascular mortality, with an adjusted hazard ratio of 3.39 (95% confidence interval 1.91 to 6.01) and 8.71 (95% confidence interval 2.98 to 25.47), respectively, comparing those with a CHADS2 score >2 versus a CHADS2 score of 0. Adding hs-CRP to a predictive model including the CHADS2 score was associated with an improvement of the C-statistic for total mortality (from 0.627 to 0.677) and for cardiovascular mortality (from 0.700 to 0.718). In conclusion, high levels of hs-CRP constitute an independent marker for the risk of mortality in patients with atrial fibrillation.

Combined use of high-sensitivity C-reactive protein and apolipoprotein B/apolipoprotein A-1 ratio prior to elective coronary angiography and oral glucose tolerance tests

Objectives The study aimed to investigate the predictive value of the combination of high-sensitivity C-reactive protein (hs-CRP) and apolipoprotein B (apoB)/apoA-1 ratio for the outcomes of coronary angiography (CAG), echocardiography and oral glucose tolerance tests (OGTTs). Design and methods Hs-CRP, apoB, apoA-1, and the profiles of CAG, echocardiography and OGTTs as well as traditional risk factors were measured in 1757 cardiology patients. Results Hs-CRP or apoB/apoA-1 ratio was significantly correlated with the presence and severity of angiographic profiles, the levels of left ventricular (LV) ejection fraction, LV mass and LV mass index, and the presence of abnormal glucose metabolism. The combination of hs-CRP and apoB/apoA-1 ratio had greater correlation with abnormal glucose metabolism than its individual components in patients with normal fasting glucose, and was an independent predictor for coronary artery disease. Conclusions The combination of hs-CRP and apoB/apoA-1 ratio may be a strong predictor for coronary artery disease and abnormal glucose metabolism.

The Role of C-Reactive Protein as a Risk Predictor of Coronary Atherosclerosis: Implications from the JUPITER Trial

Much controversy surrounds the use of high-sensitivity C-reactive protein (hs-CRP) as a marker of cardiovascular (CV) risk. Although data regarding the association of hs-CRP with CV disease is extensive and consistent, its role in clinical practice remains unclear. The American Heart Association (AHA) recently published a scientific statement regarding criteria for evaluation of novel markers of CV risk. This article provides a comprehensive review of data regarding hs-CRP as a risk marker for CV disease in the context of these AHA criteria. The impact of the JUPITER trial on the utility of hs-CRP as a risk marker is emphasized. The review concludes with an evidence-based statement regarding the current role of hs-CRP in CV risk prediction.

A practical approach to the metabolic syndrome: review of current concepts and management

Novel research over the past 2 years has necessitated an update of our 'ABCDE' approach to the metabolic syndrome. Clinical trials investigating the role of aspirin in primary prevention have led to an adjustment in the indication for aspirin in metabolic syndrome patients at intermediate risk of a cardiovascular event. There has been renewed enthusiasm for the use of niacin as second-line treatment for atherogenic dyslipidemia, with fibrates reserved for those with severe residual dyslipidemia. In light of the noteworthy findings of the Justification for the Use of statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin trial, the 'C' category representing 'cholesterol' has been expanded to include the use of high-sensitivity C-reactive protein for guiding statin use and perhaps monitoring statin therapy. Recent evidence confirms that diet and exercise continue to be the cornerstone of any metabolic syndrome treatment strategy. The revised 'ABCDE' approach incorporates the most recent influential studies into a simple yet thorough algorithm for management of the metabolic syndrome.

Primary Care and Health System Reform

Schering-Plough, Sanofi-Aventis, Isis, Siemens, and Vascular Biogenics; and being listed as a coinventor on patents held by Brigham and Women’s Hospital that relate to the use of inflammatory biomarkers in cardiovascular disease, including the use of high-sensitivity C-reactive protein in the evaluation of patients’ risk of cardiovascular disease. These patents have been licensed to Siemens and AstraZeneca. Neither of the other authors reported financial disclosures.

High-Sensitivity C-Reactive Protein Predicts Cardiovascular Risk in Diabetic and Nondiabetic Patients: Effects of Insulin-Sensitizing Treatment with Pioglitazone

Systemic inflammatory activity has turned out to play a key pathogenic role in vascular atherosclerosis, insulin resistance, and type 2 diabetes mellitus. Inflammatory biomarkers may therefore be a valuable tool for risk evaluation. Among them, the best evidence to date supports the use of high-sensitivity C-reactive protein (hs-CRP) to monitor insulin resistance and cardiovascular risk in diabetic and nondiabetic individuals. Data suggest that hs-CRP may also participate directly in the process of atherogenesis. A growing number of clinical trials tested the hypothesis that antidiabetic drugs specifically targeting insulin resistance could benefit individuals by reducing inflammation, atherogenesis, and thus cardiovascular risk. One such class are the thiazolidinediones (pioglitazone and rosiglitazone). These agents act as selective ligands of the nuclear transcription factor peroxisome proliferator-activated receptor-gamma (PPARgamma). This article reviewed published data on hs-CRP changes with the thiazolidinedione agent pioglitazone. Here we found pronounced insulin-sensitizing and anti-inflammatory properties in different clinical settings, including diabetic and nondiabetic individuals. Coadministration of pioglitazone to antilipidemic statin therapy resulted in additional effects on low-grade inflammation, and hs-CRP reduction has been demonstrated to occur independently of glucose lowering. The anti-inflammatory effect appeared to be a rapid physiologic reaction on PPARgamma activation and could be observed within a short-term interval after starting pioglitazone therapy. In summary, clinical study results underline the benefit of an early insulin resistance treatment to oppose systemic vascular inflammation and cardiometabolic syndrome in patients with elevated levels of high-sensitivity C-reactive protein.

Clinical Use of High-Sensitivity C-Reactive Protein (hs-CRP) in Chronic Pelvic Pain Syndrome

Clinical Use of High-Sensitivity C-Reactive Protein (hs-CRP) in Chronic Pelvic Pain Syndrome

Usefulness of High-Sensitivity C-Reactive Protein as a Marker of Airway Inflammation in Cough-Variant and Bronchial Asthma

Usefulness of High-Sensitivity C-Reactive Protein as a Marker of Airway Inflammation in Cough-Variant and Bronchial Asthma

Clinical Usefulness of High-Sensitivity C-Reactive Protein in Predicting Risk of the Metabolic Syndrome: Epidemiologic Evidence

C-reactive protein (CRP) is an acute-phase protein, which is primarily synthesized in the liver. In response to most forms of inflammation, infection, and tissue damage, plasma levels of CRP in human body may rise rapidly and markedly, as much as 100 or 1000-fold or more during the acute phase. In epidemiological studies, CRP levels well below the conventional clinical upper limit of 10 mg/L (as measured by high sensitivity CRP) have consistently been predictive of cardiovascular disease 1,2 and type 2 diabetes in various populations. 3 The “high sensitivity” refers to the lower detection limit of the assay procedures being used than previous commercial assays routinely used for clinical measurements. 4 Highly sensitive assays for CRP are widely used in epidemiologic studies to precisely measure values within the range less than 10 mg/L. High-sensitivity CRP thus has become a clinically useful marker oflow-grade chronic inflammation. Low-grade chronic inflammation may be one of the common antecedents underlying the clustering of obesity, impaired glucose tolerance, dyslipidemia, and hypertension, known as the metabolic syndrome. Ranges of 3 mg/L, which correspond to approximate tertiles of the CRP distribution in healthy US adults, are used to denote low-, moderate-, and high-risk cardiovascular groups. Of note, CVD and type 2 diabetes are the major sequelae of the metabolic syndrome. CRP independently predicts both CVD and type 2 diabetes, but it is unknown whether CRP evaluation is a valuable addition to the metabolic syndrome for risk assessment of CVD and diabetes.

Correlation of High Sensitivity C-Reactive Protein and Calcific Aortic Valve Disease

OBJECTIVE To determine whether a difference exists in the levels of high sensitivity C-reactive protein (Hs-CRP) in patients with and without calcific aortic valve disease (CAVD). PATIENTS AND METHODS This cross-sectional study consisted of 110 patients who had undergone echocardiographic examination from January 2005 to February 2006 at our institution. Information on demographic variables, coronary risk factors, and medications was obtained. More than 200 patients were excluded on the basis of any evidence of infection, active connective tissue disorder, rheumatoid arthritis, recent episodes of bleeding, acute fractures, bowel obstruction, or acute coronary syndrome or use of corticosteroids, nonsteroidal anti-inflammatory drugs, or antibiotic treatment. The values of Hs-CRP, total cholesterol, and erythrocyte sedimentation rate were included. RESULTS Of the 110 study subjects, 38 patients had aortic sclerosis, 36 patients had aortic stenosis, and 36 were controls. The mean Hs-CRP level in the control group was significantly lower (4.84±6.9 mg/L) compared with the levels in the groups with aortic sclerosis (14.9±19.6 mg/L) and aortic stenosis (13.6±17.3 mg/L) (P=.01). No statistically significant difference was found between the patients in the aortic sclerosis and aortic stenosis groups. Among the patients with aortic stenosis, no significant correlation existed between Hs-CRP levels and aortic stenosis severity. CONCLUSIONS The Hs-CRP seems to have a significant association with CAVD during its early stage. The study findings did not have sufficient evidence to suggest the use of Hs-CRP as a marker of progression of calcific aortic stenosis. The Hs-CRP may have a role in identifying patients in the early stages of CAVD and in whom medical treatment may be beneficial to halt the progression to irreversible aortic valvular calcification and stenosis. To determine whether a difference exists in the levels of high sensitivity C-reactive protein (Hs-CRP) in patients with and without calcific aortic valve disease (CAVD). This cross-sectional study consisted of 110 patients who had undergone echocardiographic examination from January 2005 to February 2006 at our institution. Information on demographic variables, coronary risk factors, and medications was obtained. More than 200 patients were excluded on the basis of any evidence of infection, active connective tissue disorder, rheumatoid arthritis, recent episodes of bleeding, acute fractures, bowel obstruction, or acute coronary syndrome or use of corticosteroids, nonsteroidal anti-inflammatory drugs, or antibiotic treatment. The values of Hs-CRP, total cholesterol, and erythrocyte sedimentation rate were included. Of the 110 study subjects, 38 patients had aortic sclerosis, 36 patients had aortic stenosis, and 36 were controls. The mean Hs-CRP level in the control group was significantly lower (4.84±6.9 mg/L) compared with the levels in the groups with aortic sclerosis (14.9±19.6 mg/L) and aortic stenosis (13.6±17.3 mg/L) (P=.01). No statistically significant difference was found between the patients in the aortic sclerosis and aortic stenosis groups. Among the patients with aortic stenosis, no significant correlation existed between Hs-CRP levels and aortic stenosis severity. The Hs-CRP seems to have a significant association with CAVD during its early stage. The study findings did not have sufficient evidence to suggest the use of Hs-CRP as a marker of progression of calcific aortic stenosis. The Hs-CRP may have a role in identifying patients in the early stages of CAVD and in whom medical treatment may be beneficial to halt the progression to irreversible aortic valvular calcification and stenosis.