Is C-Reactive Protein Specific for Vascular Disease in Women?

  1. Nader Rifai, PhD;
  2. Julie E. Buring, ScD;
  3. I-Min Lee, MBBS, ScD;
  4. JoAnn E. Manson, MD; and
  5. Paul M Ridker, MD
  1. From Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

    Abstract

    Background: C-reactive protein (CRP) predicts risk for future cardiovascular events in asymptomatic individuals. However, because CRP also predicts total mortality, its specificity for vascular disease is uncertain.

    Objective: To compare the predictive value of CRP for cancer and cardiovascular disease, the major determinants of mortality.

    Design: Prospective, nested case–control study.

    Setting: The Women's Health Study, an ongoing prospective cohort study involving 28 345 U.S. women 45 years of age and older who were healthy at the time of enrollment.

    Participants: 643 women who subsequently developed cancer or had cardiovascular events; 643 age- and smoking-matched women who remained free of either disease during 58-month follow-up.

    Measurements: Baseline CRP levels.

    Results: Little evidence showed that increasing quartiles of baseline CRP predicted incident cancer (adjusted relative risks, 1.0, 1.2, 1.1, and 1.3; P for trend > 0.2). In contrast, increasing quartiles of baseline CRP were a strong marker of risk for future cardiovascular disease (adjusted relative risks, 1.0, 2.9, 3.4, and 5.6; P for trend < 0.001).

    Conclusion: C-reactive protein appears to independently predict cardiovascular events but not cancer.

    Article and Author Information

    • Disclosure: Dr. Ridker is named as a co-inventor on patents related to the use of inflammatory biomarkers in cardiovascular disease.

    • Grant Support: By the National Heart, Lung, and Blood Institute (HL 58755); an Established Investigator Award from the American Heart Association (Dr. Ridker); and a Distinguished Clinical Scientist Award from the Doris Duke Charitable Foundation (Dr. Ridker).

    • Requests for Single Reprints: Paul M Ridker, MD, Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215; e-mail, pridker{at}partners.org.

    • Current Author Addresses: Dr. Rifai: Department of Laboratory Medicine, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115.

    • Drs. Buring, Lee, Manson, and Ridker: Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215.

    • Author Contributions: Conception and design: N. Rifai, P.M. Ridker.

    • Analysis and interpretation of the data: N. Rifai, J.E. Manson, P.M. Ridker.

    • Drafting of the article: N. Rifai, P.M. Ridker.

    • Critical revision of the article for important intellectual content: N. Rifai, J.E. Buring, I.-M. Lee, J.E. Manson, P.M. Ridker.

    • Final approval of the article: N. Rifai, J.E. Buring, I.-M. Lee, J.E. Manson, P.M. Ridker.

    • Provision of study materials or patients: J.E. Buring, P.M. Ridker.

    • Statistical expertise: J.E. Manson, P.M. Ridker.

    • Obtaining of funding: P.M. Ridker.

    • Administrative, technical, or logistic support: J.E. Buring, J.E. Manson.

    • Collection and assembly of data: N. Rifai, I.-M. Lee, P.M. Ridker.

    Summary for Patients

    • Summaries for Patients:Is C-Reactive Protein Specific for Vascular Disease in Women? Ann Intern Med April 2, 2002 136:I42
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    1. Ann Intern Med April 2, 2002 vol. 136 no. 7 529-533
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