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Conference Paper: C-reactive protein trends and associations with total mortality in United States adults between 1999-2010

TitleC-reactive protein trends and associations with total mortality in United States adults between 1999-2010
Authors
KeywordsCardiovascular disease
Issue Date2012
PublisherHong Kong College of Cardiology. The Journal's web site is located at http://www.hkcchk.com/journals.php#3
Citation
The 16th Annual Scientific Meeting of the Institute of Cardiovascular Science and Medicine (ICSM), Hong Kong, 17 November 2012. In Journal of the Hong Kong College of Cardiology, 2012, v. 20 n. 2, p. 53, abstract no. CP1 How to Cite?
AbstractINTRODUCTION: C-reactive protein (CRP) is a well-known biomarker of systemic inflammation. Elevation of CRP levels is predictive of incident cardiovascular disease morbidity and mortality. We investigated the trends in prevalence of elevated CRP levels (>3.0 mg/L), as well as mean CRP levels, in a general population of United States adults and then determine the associations with mortality. METHODS: Data from the 27,214 subjects aged ≥20 years in the National Health and Nutrition Examination Survey (NHANES) 1999-2010 were analyzed. Among them, 12,259 subjects from NHANES 1999-2004 had mortality data followed up through December 31, 2006. RESULTS: After adjusting for age, sex, race/ethnicity, body mass index, and medications for lowering blood pressure, glucose and lipids, the prevalence of elevated CRP decreased significantly from 36.7% in 1999-2002 to 32.0% in 2007-2010, corresponding to a decrease in mean CRP levels from 1.92 to 1.66 mg/L (both P<0.001). The trend remained significant after additional adjustment for several traditional cardiovascular risk factors and use of medications, including statins, angiotensin-converting enzyme inhibitors, metformin, aspirin and clopidogrel. However, the decreasing trends were attenuated after additional adjustment for total bilirubin (P=0.076 and 0.024), which increased from 0.62 to 0.73 mg/dL over 12 years (P<0.001). Of note, higher CRP levels were modestly associated with a higher risk of total mortality (adjusted hazard ratio: 1.07 [95%CI, 1.03-1.12] per 10 mg/L increase, P=0.001), and this association tended to be stronger in subjects with higher total bilirubin levels (P for interaction <0.001). CONCLUSION: The decreasing trend of CRP levels is encouraging and may be related to the increase in total bilirubin levels. Such trends may be explained in part by the increasing use of some medications such as statins that can increase bilirubin levels and decrease CRP levels. Moreover, the prediction of total mortality by CRP levels seems to be stronger in subjects with higher total bilirubin levels.
DescriptionChaired Posters
Persistent Identifierhttp://hdl.handle.net/10722/177473
ISSN
2015 SCImago Journal Rankings: 0.102

 

DC FieldValueLanguage
dc.contributor.authorOng, KLen_US
dc.contributor.authorAllison, MAen_US
dc.contributor.authorCheung, BMYen_US
dc.contributor.authorWu, BJen_US
dc.contributor.authorBarter, PJen_US
dc.contributor.authorRye, KAen_US
dc.date.accessioned2012-12-18T05:12:03Z-
dc.date.available2012-12-18T05:12:03Z-
dc.date.issued2012en_US
dc.identifier.citationThe 16th Annual Scientific Meeting of the Institute of Cardiovascular Science and Medicine (ICSM), Hong Kong, 17 November 2012. In Journal of the Hong Kong College of Cardiology, 2012, v. 20 n. 2, p. 53, abstract no. CP1en_US
dc.identifier.issn1027-7811-
dc.identifier.urihttp://hdl.handle.net/10722/177473-
dc.descriptionChaired Posters-
dc.description.abstractINTRODUCTION: C-reactive protein (CRP) is a well-known biomarker of systemic inflammation. Elevation of CRP levels is predictive of incident cardiovascular disease morbidity and mortality. We investigated the trends in prevalence of elevated CRP levels (>3.0 mg/L), as well as mean CRP levels, in a general population of United States adults and then determine the associations with mortality. METHODS: Data from the 27,214 subjects aged ≥20 years in the National Health and Nutrition Examination Survey (NHANES) 1999-2010 were analyzed. Among them, 12,259 subjects from NHANES 1999-2004 had mortality data followed up through December 31, 2006. RESULTS: After adjusting for age, sex, race/ethnicity, body mass index, and medications for lowering blood pressure, glucose and lipids, the prevalence of elevated CRP decreased significantly from 36.7% in 1999-2002 to 32.0% in 2007-2010, corresponding to a decrease in mean CRP levels from 1.92 to 1.66 mg/L (both P<0.001). The trend remained significant after additional adjustment for several traditional cardiovascular risk factors and use of medications, including statins, angiotensin-converting enzyme inhibitors, metformin, aspirin and clopidogrel. However, the decreasing trends were attenuated after additional adjustment for total bilirubin (P=0.076 and 0.024), which increased from 0.62 to 0.73 mg/dL over 12 years (P<0.001). Of note, higher CRP levels were modestly associated with a higher risk of total mortality (adjusted hazard ratio: 1.07 [95%CI, 1.03-1.12] per 10 mg/L increase, P=0.001), and this association tended to be stronger in subjects with higher total bilirubin levels (P for interaction <0.001). CONCLUSION: The decreasing trend of CRP levels is encouraging and may be related to the increase in total bilirubin levels. Such trends may be explained in part by the increasing use of some medications such as statins that can increase bilirubin levels and decrease CRP levels. Moreover, the prediction of total mortality by CRP levels seems to be stronger in subjects with higher total bilirubin levels.-
dc.languageengen_US
dc.publisherHong Kong College of Cardiology. The Journal's web site is located at http://www.hkcchk.com/journals.php#3-
dc.relation.ispartofJournal of the Hong Kong College of Cardiologyen_US
dc.subjectCardiovascular disease-
dc.titleC-reactive protein trends and associations with total mortality in United States adults between 1999-2010en_US
dc.typeConference_Paperen_US
dc.identifier.emailOng, KL: okl2000@hku.hken_US
dc.identifier.emailCheung, BMY: mycheung@hku.hk-
dc.identifier.authorityCheung, BMY=rp01321en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros212522en_US
dc.identifier.volume20en_US
dc.identifier.issue2en_US
dc.identifier.spage53en_US
dc.identifier.epage53en_US
dc.publisher.placeHong Kong-
dc.description.otherThe 16th Annual Scientific Meeting of the Institute of Cardiovascular Science and Medicine (ICSM), Hong Kong, 17 November 2012. In Journal of the Hong Kong College of Cardiology, 2012, v. 20 n. 2, p. 53, abstract no. CP1-

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