Combination of high-sensitivity C-reactive protein and homocysteine may predict an increased risk of coronary artery disease in Korean population

Chinese Medical Journal, 02/22/2012

Doo-Yeoun C et al. - The present study demonstrated that high-sensitivity C-reactive protein (hs-CRP) and homocysteine are well associated with the 10-year coronary artery disease (CAD) risk estimated using NCEP ATP III in Koreans and combination of hs-CRP and homocysteine can have strong synergy in predicting the development of CAD.

Methods

  • A total of 10 650 subjects (6538 men and 4112 women) were enrolled in this study.
  • A 10-year CAD risk was calculated using Framingham risk score modified by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) and levels of circulating hs-CRP, homocysteine and fibrinogen were measured using validated assays.

Results

  • The 10-year CAD risk gradually augmented with increase in the circulating levels of hs-CRP, homocysteine and fibrinogen.
  • For the highest quartile of hs-CRP, odds ratio (OR) of high-risk for CAD (10-year risk ≥20%) compared with the lowest quartile was 3.97 (95% CI: 2.51–6.29).
  • For homocysteine and fibrinogen, ORs in the highest quartile compared to the lowest quartile were 5.10 (95% CI: 3.05–8.53, P <0.001) and 1.46 (95% CI: 0.69–3.11, P=0.325), respectively.
  • OR of high-risk for CAD in both the highest quartile of hs-CRP and homocysteine was 9.05 (95% CI: 5.30–15.45) compared with the below median of hs-CRP and homocysteine.

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