Association between high-sensitivity C-reactive protein and coronary plaque subtypes assessed by 64-slice coronary computed tomography angiography in an asymptomatic population

Jonathan Rubin, Hyuk-Jae Chang, Khurram Nasir, Roger S. Blumenthal, Michael J. Blaha, Eue Keun Choi, Sung A. Chang, Yeonyee E. Yoon, Eun Ju Chun, Sang Il Choi, Arthur S. Agatston, Juan J. Rivera

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background-Elevated levels of C-reactive protein (CRP) are associated with poor cardiovascular outcomes, even after accounting for traditional cardiovascular risk factors. We sought to analyze the relationship between levels of CRP and coronary plaque subtypes as assessed by coronary computed tomography angiography. Methods and Results-We evaluated 1004 asymptomatic South Korean subjects (mean age, 49±9.3 years) who underwent coronary computed tomography angiography as part of a health screening evaluation. We examined the association between increasing CRP levels and plaque subtypes using multivariable linear and logistic regression analysis. Coronary plaque was observed in 211 of 1004 individuals (21%). Subjects with high CRP (≤2 mg/L) had an increased prevalence of any plaque type (30.7% versus 16.7% P<0.001) and mixed calcified arterial plaque (MCAP) (19.3% versus 6.3% P<0.001) as compared with subjects with low-normal CRP. Multivariable logistic regression analysis demonstrated that elevated CRP predicted the presence of any MCAP (high versus low-normal CRP group; odds ratio, 2.81; 95% confidence interval, 1.62 to 4.89). When examining the multivariable logistic regression analysis between the presence of ≥2 plaques and CRP, subjects with high CRP were more likely to have MCAP than those with low-normal CRP levels (odds ratio, 3.78; 95% confidence interval, 1.49 to 9.55). Conclusions-Elevated levels of CRP are associated with an increased prevalence of MCAP as assessed by coronary computed tomography angiography. Longitudinal studies will determine if the excess risk observed in persons with elevated CRP may be mediated, at least in part, by an increased burden of MCAP.

Original languageEnglish
Pages (from-to)201-209
Number of pages9
JournalCirculation: Cardiovascular Imaging
Volume4
Issue number3
DOIs
Publication statusPublished - 2011 May 1

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C-Reactive Protein
Population
Logistic Models
Regression Analysis
Computed Tomography Angiography
Odds Ratio
Confidence Intervals
Longitudinal Studies
Linear Models

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Rubin, Jonathan ; Chang, Hyuk-Jae ; Nasir, Khurram ; Blumenthal, Roger S. ; Blaha, Michael J. ; Choi, Eue Keun ; Chang, Sung A. ; Yoon, Yeonyee E. ; Chun, Eun Ju ; Choi, Sang Il ; Agatston, Arthur S. ; Rivera, Juan J. / Association between high-sensitivity C-reactive protein and coronary plaque subtypes assessed by 64-slice coronary computed tomography angiography in an asymptomatic population. In: Circulation: Cardiovascular Imaging. 2011 ; Vol. 4, No. 3. pp. 201-209.
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abstract = "Background-Elevated levels of C-reactive protein (CRP) are associated with poor cardiovascular outcomes, even after accounting for traditional cardiovascular risk factors. We sought to analyze the relationship between levels of CRP and coronary plaque subtypes as assessed by coronary computed tomography angiography. Methods and Results-We evaluated 1004 asymptomatic South Korean subjects (mean age, 49±9.3 years) who underwent coronary computed tomography angiography as part of a health screening evaluation. We examined the association between increasing CRP levels and plaque subtypes using multivariable linear and logistic regression analysis. Coronary plaque was observed in 211 of 1004 individuals (21{\%}). Subjects with high CRP (≤2 mg/L) had an increased prevalence of any plaque type (30.7{\%} versus 16.7{\%} P<0.001) and mixed calcified arterial plaque (MCAP) (19.3{\%} versus 6.3{\%} P<0.001) as compared with subjects with low-normal CRP. Multivariable logistic regression analysis demonstrated that elevated CRP predicted the presence of any MCAP (high versus low-normal CRP group; odds ratio, 2.81; 95{\%} confidence interval, 1.62 to 4.89). When examining the multivariable logistic regression analysis between the presence of ≥2 plaques and CRP, subjects with high CRP were more likely to have MCAP than those with low-normal CRP levels (odds ratio, 3.78; 95{\%} confidence interval, 1.49 to 9.55). Conclusions-Elevated levels of CRP are associated with an increased prevalence of MCAP as assessed by coronary computed tomography angiography. Longitudinal studies will determine if the excess risk observed in persons with elevated CRP may be mediated, at least in part, by an increased burden of MCAP.",
author = "Jonathan Rubin and Hyuk-Jae Chang and Khurram Nasir and Blumenthal, {Roger S.} and Blaha, {Michael J.} and Choi, {Eue Keun} and Chang, {Sung A.} and Yoon, {Yeonyee E.} and Chun, {Eun Ju} and Choi, {Sang Il} and Agatston, {Arthur S.} and Rivera, {Juan J.}",
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Association between high-sensitivity C-reactive protein and coronary plaque subtypes assessed by 64-slice coronary computed tomography angiography in an asymptomatic population. / Rubin, Jonathan; Chang, Hyuk-Jae; Nasir, Khurram; Blumenthal, Roger S.; Blaha, Michael J.; Choi, Eue Keun; Chang, Sung A.; Yoon, Yeonyee E.; Chun, Eun Ju; Choi, Sang Il; Agatston, Arthur S.; Rivera, Juan J.

In: Circulation: Cardiovascular Imaging, Vol. 4, No. 3, 01.05.2011, p. 201-209.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between high-sensitivity C-reactive protein and coronary plaque subtypes assessed by 64-slice coronary computed tomography angiography in an asymptomatic population

AU - Rubin, Jonathan

AU - Chang, Hyuk-Jae

AU - Nasir, Khurram

AU - Blumenthal, Roger S.

AU - Blaha, Michael J.

AU - Choi, Eue Keun

AU - Chang, Sung A.

AU - Yoon, Yeonyee E.

AU - Chun, Eun Ju

AU - Choi, Sang Il

AU - Agatston, Arthur S.

AU - Rivera, Juan J.

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Background-Elevated levels of C-reactive protein (CRP) are associated with poor cardiovascular outcomes, even after accounting for traditional cardiovascular risk factors. We sought to analyze the relationship between levels of CRP and coronary plaque subtypes as assessed by coronary computed tomography angiography. Methods and Results-We evaluated 1004 asymptomatic South Korean subjects (mean age, 49±9.3 years) who underwent coronary computed tomography angiography as part of a health screening evaluation. We examined the association between increasing CRP levels and plaque subtypes using multivariable linear and logistic regression analysis. Coronary plaque was observed in 211 of 1004 individuals (21%). Subjects with high CRP (≤2 mg/L) had an increased prevalence of any plaque type (30.7% versus 16.7% P<0.001) and mixed calcified arterial plaque (MCAP) (19.3% versus 6.3% P<0.001) as compared with subjects with low-normal CRP. Multivariable logistic regression analysis demonstrated that elevated CRP predicted the presence of any MCAP (high versus low-normal CRP group; odds ratio, 2.81; 95% confidence interval, 1.62 to 4.89). When examining the multivariable logistic regression analysis between the presence of ≥2 plaques and CRP, subjects with high CRP were more likely to have MCAP than those with low-normal CRP levels (odds ratio, 3.78; 95% confidence interval, 1.49 to 9.55). Conclusions-Elevated levels of CRP are associated with an increased prevalence of MCAP as assessed by coronary computed tomography angiography. Longitudinal studies will determine if the excess risk observed in persons with elevated CRP may be mediated, at least in part, by an increased burden of MCAP.

AB - Background-Elevated levels of C-reactive protein (CRP) are associated with poor cardiovascular outcomes, even after accounting for traditional cardiovascular risk factors. We sought to analyze the relationship between levels of CRP and coronary plaque subtypes as assessed by coronary computed tomography angiography. Methods and Results-We evaluated 1004 asymptomatic South Korean subjects (mean age, 49±9.3 years) who underwent coronary computed tomography angiography as part of a health screening evaluation. We examined the association between increasing CRP levels and plaque subtypes using multivariable linear and logistic regression analysis. Coronary plaque was observed in 211 of 1004 individuals (21%). Subjects with high CRP (≤2 mg/L) had an increased prevalence of any plaque type (30.7% versus 16.7% P<0.001) and mixed calcified arterial plaque (MCAP) (19.3% versus 6.3% P<0.001) as compared with subjects with low-normal CRP. Multivariable logistic regression analysis demonstrated that elevated CRP predicted the presence of any MCAP (high versus low-normal CRP group; odds ratio, 2.81; 95% confidence interval, 1.62 to 4.89). When examining the multivariable logistic regression analysis between the presence of ≥2 plaques and CRP, subjects with high CRP were more likely to have MCAP than those with low-normal CRP levels (odds ratio, 3.78; 95% confidence interval, 1.49 to 9.55). Conclusions-Elevated levels of CRP are associated with an increased prevalence of MCAP as assessed by coronary computed tomography angiography. Longitudinal studies will determine if the excess risk observed in persons with elevated CRP may be mediated, at least in part, by an increased burden of MCAP.

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DO - 10.1161/CIRCIMAGING.109.929901

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