Format

Send to

Choose Destination
Diabetes Obes Metab. 2018 Mar;20(3):654-659. doi: 10.1111/dom.13136. Epub 2017 Nov 21.

High-sensitivity C-reactive protein, low-density lipoprotein cholesterol and cardiovascular outcomes in patients with type 2 diabetes in the EXAMINE (Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care) trial.

Author information

1
Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
2
Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
3
Baim Institute for Clinical Research, Boston, Massachusetts.
4
International Diabetes Center, Park-Nicollet Clinic, Minneapolis, Minnesota.
5
University of Sheffield, Sheffield, UK.
6
Harvard School of Public Health, Boston, Massachusetts.
7
University of Tennessee College of Medicine, Memphis, Tennessee.
8
University of Chicago Med, Chicago, Illinois.
9
Universite de Lorraine, Nancy, France.
10
University of Connecticut School of Medicine, Farmington, Connecticut.

Abstract

AIMS:

We sought to assess the risk of major adverse cardiovascular events (MACE) by utilizing high-sensitivity C-reactive protein (hsCRP) level and low-density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes and recent acute coronary syndrome.

MATERIALS AND METHODS:

Study participants enrolled in the EXAMINE trial (Clinical trials registration number: NCT00968708) and were stratified by baseline hsCRP levels (<1, 1-3 and >3 mg/L). They were also sub-divided into 4 groups according to baseline hsCRP (≤3 or >3 mg/L) and achieved LDL-C (<70 or ≥70 mg/dL) levels. Among 5380 patients, the MACE rate, a composite of cardiovascular death, non-fatal acute myocardial infarction and non-fatal stroke, was evaluated during the 30 months of follow-up.

RESULTS:

Cumulative incidence of MACE was 11.5% (119 events), 14.6% (209 events) and 18.4% (287 events) in patients with hsCRP levels of <1, 1 to 3 and >3 mg/L, respectively (P < .001). In patients with hsCRP >3 mg/L, the adjusted hazard ratio (95% confidence interval) was 1.42 (1.13, 1.78; P = .002) for MACE compared with patients with hsCRP <1 mg/L. MACE cumulative incidences were 11.0% (128 events), 14.4% (100 events), 15.6% (194 events) and 21.3% (182 events) in patients with low LDL-C and low hsCRP, low LDL-C and high hsCRP, high LDL-C and low hsCRP, and high LDL-C and high hsCRP levels, respectively (P < .001).

CONCLUSIONS:

Levels of hsCRP were associated with recurrent cardiovascular events in patients with type 2 diabetes and recent acute coronary syndrome, and this association appears to be independent of and additive to the achieved LDL-C level.

KEYWORDS:

LDL cholesterol; acute coronary syndromes; cardiovascular outcomes; high-sensitivity C-reactive protein; type 2 diabetes

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center