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C-Reactive Protein and Traditional Coronary Risk Factors

In a population-based study, elevated CRP levels were highly correlated with traditional coronary risk factors.

C-reactive protein (CRP) levels predict a wide range of cardiovascular outcomes. However, given CRP’s strong association with other coronary risk factors, and given the lack of evidence that basing therapeutic decisions on CRP levels improves outcomes, it is not recommended for routine screening. Investigators analyzed data on more than 15,000 adults from the Third National Health and Nutrition Examination Survey to determine whether CRP levels are associated with the presence of conventional coronary risk factors.

Among the 813 people who were normotensive, euglycemic, normolipidemic, and not overweight, and who never smoked, 9% had elevated CRP levels (>3 mg/dL). In contrast, among the remaining 14,528 people — all of whom had one or more abnormal or borderline risk factor — 27% had elevated CRP levels. The presence of at least one abnormal or borderline risk factor accounted for 78% of the risk for having an elevated CRP level in men, and 67% of the risk in women.

Comment: The results of this population-based study show that elevated C-reactive protein levels are highly correlated with the presence of one or more traditional coronary risk factors. The findings reaffirm current CDC and American Heart Association guidelines that maintain a focus on identifying and modifying traditional risk factors, rather than screening for CRP in the general population.

— Jamaluddin Moloo, MD, MPH

Published in Journal Watch General Medicine November 4, 2005

Citation(s):

Miller M et al. High attributable risk of elevated C-reactive protein level to conventional coronary heart disease risk factors: The Third National Health and Nutrition Examination Survey. Arch Intern Med 2005 Oct 10; 165:2063-8.

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