PMID- 30121016
STAT- In-Data-Review
LR  - 20181102
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 204
DP  - 2018 Oct
TI  - High-sensitivity C-reactive protein elevation in patients with prior myocardial
      infarction in the United States.
PG  - 151-155
LID - S0002-8703(18)30224-2 [pii]
LID - 10.1016/j.ahj.2018.07.014 [doi]
AB  - IMPORTANCE: The extent to which levels of high-sensitivity C-reactive protein
      (hs-CRP), a known marker of increased cardiovascular risk, are elevated and are
      associated with standard cardiovascular risk factors in patients with a history
      of myocardial infarction (MI) is unknown. OBJECTIVES: To determine the pattern
      and determinants of the distribution of hs-CRP in those with a prior MI in the
      United States using a nationally representative sample. DESIGN AND PARTICIPANTS: 
      Adults with hs-CRP data in the National Health and Nutrition Examination Surveys 
      from 1999-2010. RESULTS: Among 1296 individuals in our cohort, the median age was
      65 years and the median hs-CRP level was 2.69 mg/L, measured an average of 7.1
      years after the MI. Among these patients, 22% had hs-CRP levels of <1 mg/L, 61%
      had >/=2 mg/L, and 48% had >/=3 mg/L. Increasing hs-CRP was associated in a
      multivariable model with increasing body mass index (partial R(2) [pR(2)] 0.113, 
      P < .001), increasing non-high-density lipoprotein [HDL] (pR(2) 0.030, P < .001),
      increasing age (pR(2) 0.008, P = .017), and decreasing HDL (pR(2) 0.005, P =
      .046). Adjusted mean hs-CRP was also higher in women (3.6 vs 2.7 mg/L; P < .001),
      in people with hypertension (3.5 vs. 2.8, P = .030), and among smokers (4.2 vs
      2.3 mg/L; P < .001), and lower in people with hyperlipidemia (2.8 vs. 3.5, P =
      .007). Standard cardiovascular risk factors accounted for only 22% of the
      variability in hs-CRP levels. CONCLUSIONS AND RELEVANCE: Among patients with
      prior MI, elevated hs-CRP is prevalent several years after the MI, and standard
      cardiovascular risk factors explain only a small proportion of hs-CRP
      variability. In light of emerging evidence on the importance of inflammation in
      the pathogenesis of cardiovascular disease, the high prevalence of elevated
      hs-CRP in patients with prior MI in the United States may have public health
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Pagidipati, Neha J
AU  - Pagidipati NJ
AD  - Duke Clinical Research Institute, Duke University, Durham, NC. Electronic
FAU - Hellkamp, Anne S
AU  - Hellkamp AS
AD  - Duke Clinical Research Institute, Duke University, Durham, NC.
FAU - Sharma, Puza P
AU  - Sharma PP
AD  - Novartis Pharmaceutical Corporation, East Hanover, NJ.
FAU - Wang, Tracy Y
AU  - Wang TY
AD  - Duke Clinical Research Institute, Duke University, Durham, NC.
FAU - Fonarow, Gregg C
AU  - Fonarow GC
AD  - David Geffen School of Medicine, University of California Los Angeles, Los
      Angeles, CA.
FAU - Pencina, Michael
AU  - Pencina M
AD  - Duke Clinical Research Institute, Duke University, Durham, NC.
LA  - eng
PT  - Journal Article
DEP - 20180727
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
EDAT- 2018/08/19 06:00
MHDA- 2018/08/19 06:00
CRDT- 2018/08/19 06:00
PHST- 2018/07/24 00:00 [received]
PHST- 2018/07/24 00:00 [accepted]
PHST- 2018/08/19 06:00 [pubmed]
PHST- 2018/08/19 06:00 [medline]
PHST- 2018/08/19 06:00 [entrez]
AID - S0002-8703(18)30224-2 [pii]
AID - 10.1016/j.ahj.2018.07.014 [doi]
PST - ppublish
SO  - Am Heart J. 2018 Oct;204:151-155. doi: 10.1016/j.ahj.2018.07.014. Epub 2018 Jul