scholarly journals Serum Alkaline Phosphatase and Risk of Incident Cardiovascular Disease: Interrelationship with High Sensitivity C-Reactive Protein

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0132822 ◽  
Author(s):  
Setor K. Kunutsor ◽  
Stephan J. L. Bakker ◽  
Jenny E. Kootstra-Ros ◽  
Ronald T. Gansevoort ◽  
John Gregson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Incident Cardiovascular Disease

scholarly journals Markers of Myocardial Stress, Myocardial Injury, and Subclinical Inflammation and the Risk of Sudden Death

Circulation ◽  
2020 ◽  
Vol 142 (12) ◽  
pp. 1148-1158
Author(s):  
Brendan M. Everett ◽  
M.V. Moorthy ◽  
Jani T. Tikkanen ◽  
Nancy R. Cook ◽  
Christine M. Albert
Keyword(s):  
Cardiovascular Disease ◽  
High Density Lipoprotein ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Cholesterol Ratio ◽  
Reactive Protein

Background: The majority of sudden cardiac deaths (SCDs) occur in low-risk populations often as the first manifestation of cardiovascular disease (CVD). Biomarkers are screening tools that may identify subclinical cardiovascular disease and those at elevated risk for SCD. We aimed to determine whether the total to high-density lipoprotein cholesterol ratio, high-sensitivity cardiac troponin I, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or high-sensitivity C-reactive protein individually or in combination could identify individuals at higher SCD risk in large, free-living populations with and without cardiovascular disease. Methods: We performed a nested case-control study within 6 prospective cohort studies using 565 SCD cases matched to 1090 controls (1:2) by age, sex, ethnicity, smoking status, and presence of cardiovascular disease. Results: The median study follow-up time until SCD was 11.3 years. When examined as quartiles or continuous variables in conditional logistic regression models, each of the biomarkers was significantly and independently associated with SCD risk after mutually controlling for cardiac risk factors and other biomarkers. The mutually adjusted odds ratios for the top compared with the bottom quartile were 1.90 (95% CI, 1.30–2.76) for total to high-density lipoprotein cholesterol ratio, 2.59 (95% CI, 1.76–3.83) for high-sensitivity cardiac troponin I, 1.65 (95% CI, 1.12–2.44) for NT-proBNP, and 1.65 (95% CI, 1.13–2.41) for high-sensitivity C-reactive protein. A biomarker score that awarded 1 point when the concentration of any of those 4 biomarkers was in the top quartile (score range, 0–4) was strongly associated with SCD, with an adjusted odds ratio of 1.56 (95% CI, 1.37–1.77) per 1-unit increase in the score. Conclusions: Widely available measures of lipids, subclinical myocardial injury, myocardial strain, and vascular inflammation show significant independent associations with SCD risk in apparently low-risk populations. In combination, these measures may have utility to identify individuals at risk for SCD.

scholarly journals High-sensitivity C reactive protein as a predictor of inhospital mortality in patients with cardiovascular disease at an emergency department: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015112 ◽  
Author(s):  
Ryo Yoshinaga ◽  
Yasufumi Doi ◽  
Katsuhiko Ayukawa ◽  
Shizukiyo Ishikawa
Keyword(s):  
Cardiovascular Disease ◽  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
High Sensitivity ◽  
Inhospital Mortality ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

ObjectiveWe investigated whether serum high-sensitivity C reactive protein (hs-CRP) levels measured in an emergency department (ED) are associated with inhospital mortality in patients with cardiovascular disease (CVD).DesignA retrospective cohort study.SettingED of a teaching hospital in Japan.Participants12 211 patients with CVD aged ≥18 years who presented to the ED by an ambulance between 1 February 2006 and 30 September 2014 were evaluated.Main outcome measuresInhospital mortality.Results1156 patients had died. The inhospital mortality increased significantly with the hs-CRP levels (<3.0 mg/L: 7.0%, 95% CI 6.4 to 7.6; 3.1–5.4 mg/L: 9.6%, 95% CI 7.9 to 11.3: 5.5–11.5 mg/L: 11.2%, 95% CI 9.4 to 13.0; 11.6–33.2 mg/L: 12.3%, 95% CI 10.5 to 14.1 and ≥33.3 mg/L: 19.9%, 95% CI 17.6 to 22.2). The age-adjusted and sex-adjusted HR for total mortality was increased significantly in the three ≥5.5 mg/L groups compared with the <3.0 mg/L group (5.5–11.5 mg/L: HR=1.32, 95% CI 1.09 to 1.60, p=0.005; 11.6–33.2 mg/L: HR=1.38, 95% CI 1.14 to 1.65, p=0.001 and ≥33.3 mg/L: HR=2.15, 95% CI 1.84 to 2.51, p<0.001). Similar findings were observed for the CVD subtypes of acute myocardial infarction, heart failure, cerebral infarction and intracerebral haemorrhage. This association remained unchanged even after adjustment for age, sex and white cell count and withstood Bonferroni adjustment for multiple testing. When the causes of death were divided into primary CVD and non-CVD deaths, the association between initial hs-CRP levels and mortality remained significant, but the influence of hs-CRP levels was greater in non-CVD deaths than CVD deaths. The percentage of non-CVD deaths increased with hs-CRP levels; among the patients with hs-CRP levels ≥33.3 mg/L, non-CVD deaths accounted for 37.5% of total deaths.ConclusionOur findings suggest that increased hs-CRP is a significant risk factor for inhospital mortality among patients with CVD in an ED. Particular attention should be given to our finding that non-CVD death is a major cause of death among patients with CVD with higher hs-CRP levels.

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