Discordant association of C-reactive protein with clinical events and coronary luminal narrowing in postmenopausal women: data from the Women's Angiographic Vitamin and Estrogen (WAVE) study.
Discordant association of C-reactive protein with clinical events and coronary luminal narrowing in postmenopausal women: data from the Women's Angiographic Vitamin and Estrogen (WAVE) study.
Available online from MWHC library: 1976 - present, Available in print through MWHC library:1999-2007
BACKGROUND: The incidence of cardiovascular events had been shown to be associated with C-reactive protein (CRP). However, it is unclear that the cardiovascular risk associated with CRP is due to progressive coronary narrowing or to other factors such as formation of unstable plaque. This study was designed to determine the effect of baseline CRP on cardiovascular events and on the progression of atherosclerotic narrowing among 423 postmenopausal women with angiographic stenosis between 15% and 75%. CONCLUSIONS: Higher baseline CRP was associated with increased risk of clinical events but was not associated with annualized 20140821 in luminal diameters. Thus, increased risk of adverse events among patients with higher baseline CRP events was independent of progression of atherosclerosis as measured by 20140821 in minimal or average luminal diameter. 2013 Wiley Periodicals, Inc. HYPOTHESIS: Baseline CRP levels may affect cardiovascular events and progression of atherosclerotic coronary artery narrowing among postmenopausal women. METHODS: Baseline and follow-up (2.8 years) angiographic data were analyzed among 320 women. Women were stratified into 4 quartiles according to baseline CRP levels. The 140821s in lumen diameter and clinical events in each quartile were compared. RESULTS: The annualized 140821s in minimal and average lumen diameter in diseased and nondiseased coronary segments were not significantly associated with baseline CRP levels. The composite end point of all-cause mortality and myocardial infarction (MI) increased from 3% (3/107) in the first CRP quartile to 14% (14/98) in fourth CRP quartile (P < 0.001). Similar results were found for cardiovascular death and MI (increased from 1% (2/107) in the first quartile to 11% (11/98) in fourth quartile). The difference remained significant even after adjustment for baseline differences and cardiovascular risk factors.
English
0160-9289
*C-Reactive Protein/me [Metabolism]
*Coronary Angiography
*Coronary Stenosis/bl [Blood]
*Estrogens/tu [Therapeutic Use]
*Postmenopause/bl [Blood]
*Vitamins/tu [Therapeutic Use]
Aged
Biological Markers/bl [Blood]
Coronary Stenosis/dt [Drug Therapy]
Coronary Stenosis/ra [Radiography]
Disease Progression
Female
Follow-Up Studies
Humans
Middle Aged
Prognosis
Retrospective Studies
MedStar Health Research Institute
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Medicine/Gastroenterology
Medicine/Internal Medicine
Journal Article
Multicenter Study
Randomized Controlled Trial
Available online from MWHC library: 1976 - present, Available in print through MWHC library:1999-2007
BACKGROUND: The incidence of cardiovascular events had been shown to be associated with C-reactive protein (CRP). However, it is unclear that the cardiovascular risk associated with CRP is due to progressive coronary narrowing or to other factors such as formation of unstable plaque. This study was designed to determine the effect of baseline CRP on cardiovascular events and on the progression of atherosclerotic narrowing among 423 postmenopausal women with angiographic stenosis between 15% and 75%. CONCLUSIONS: Higher baseline CRP was associated with increased risk of clinical events but was not associated with annualized 20140821 in luminal diameters. Thus, increased risk of adverse events among patients with higher baseline CRP events was independent of progression of atherosclerosis as measured by 20140821 in minimal or average luminal diameter. 2013 Wiley Periodicals, Inc. HYPOTHESIS: Baseline CRP levels may affect cardiovascular events and progression of atherosclerotic coronary artery narrowing among postmenopausal women. METHODS: Baseline and follow-up (2.8 years) angiographic data were analyzed among 320 women. Women were stratified into 4 quartiles according to baseline CRP levels. The 140821s in lumen diameter and clinical events in each quartile were compared. RESULTS: The annualized 140821s in minimal and average lumen diameter in diseased and nondiseased coronary segments were not significantly associated with baseline CRP levels. The composite end point of all-cause mortality and myocardial infarction (MI) increased from 3% (3/107) in the first CRP quartile to 14% (14/98) in fourth CRP quartile (P < 0.001). Similar results were found for cardiovascular death and MI (increased from 1% (2/107) in the first quartile to 11% (11/98) in fourth quartile). The difference remained significant even after adjustment for baseline differences and cardiovascular risk factors.
English
0160-9289
*C-Reactive Protein/me [Metabolism]
*Coronary Angiography
*Coronary Stenosis/bl [Blood]
*Estrogens/tu [Therapeutic Use]
*Postmenopause/bl [Blood]
*Vitamins/tu [Therapeutic Use]
Aged
Biological Markers/bl [Blood]
Coronary Stenosis/dt [Drug Therapy]
Coronary Stenosis/ra [Radiography]
Disease Progression
Female
Follow-Up Studies
Humans
Middle Aged
Prognosis
Retrospective Studies
MedStar Health Research Institute
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Medicine/Gastroenterology
Medicine/Internal Medicine
Journal Article
Multicenter Study
Randomized Controlled Trial