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Titre du document / Document title

C-reactive protein and prediction of coronary heart disease and global vascular events in the prospective study of pravastatin in the elderly at risk (PROSPER)

Auteur(s) / Author(s)

PROSPER Study Group
SATTAR Naveed (1) ; MURRAY Heather M. (2) ; MCCONNACHIE Alex (2) ; BLAUW Gerard J. (3) ; BOLLEN Edward L. E. M. (4) ; BUCKLEY Brendan M. (5) ; COBBE Stuart M. (6) ; FORD Ian (2) ; GAW Allan (7) ; HYLAND Michael (8) ; WOUTER JUKEMA J. (9) ; KAMPER Adriaan M. (3) ; MACFARLANE Peter W. (6) ; MURPHY Michael B. (5) ; PACKARD Chris J. (1) ; PERRY Ivan J. (10) ; STOTT David J. (11) ; SWEENEY Brian J. (12) ; TWOMEY Cillian (8) ; WESTENDORP Rudi G. J. (3) ; SHEPHERD James (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Vascular Biochemistry, University of Glasgow, Glasgow, Scotland, ROYAUME-UNI
(2) Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, ROYAUME-UNI
(3) Section of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, PAYS-BAS
(4) Department of Neurology, Leiden University Medical Centre, Leiden, PAYS-BAS
(5) Department of Pharmacology and Therapeutics, Cork University Hospital, Wilton, Cork, IRLANDE
(6) Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, ROYAUME-UNI
(7) Clinical Trials Unit, North Glasgow Division, Greater Glasgow Health Board, Glasgow, Scotland, ROYAUME-UNI
(8) Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, IRLANDE
(9) Department of Cardiology, Leiden University Medical Centre, Leiden, PAYS-BAS
(10) Department of Epidemiology and Public Health, Cork University Hospital, Wilton, Cork, IRLANDE
(11) Department of Geriatric Medicine, University of Glasgow, Glasgow, Scotland, ROYAUME-UNI
(12) Department of Neurology, Cork University Hospital, Wilton, Cork, IRLANDE

Résumé / Abstract

Background-The role of C-reactive protein (CRP) in predicting vascular events and response to statin therapy remains uncertain. Additional large prospective studies are required. Methods and Results-Baseline CRP was related to risk over 3.2 years for primary a combined end point (definite or suspected death from coronary heart disease, nonfatal myocardial infarction, and fatal or nonfatal stroke; n=865 events) and secondary (coronary heart disease events or stroke alone) and tertiary (stroke plus transient ischemic attack) end points in the Prospective Study of Pravastatin in the Elderly at Risk (n=5804 men and women; age, 70 to 82 years). CRP levels were higher in subjects who had a subsequent primary end-point event compared with those who did not (geometric mean; 3.64 mg/L [SD, 3.08 mg/L] versus 3.01 mg/L [SD, 3.05 mg/L]; P<0.0001). CRP correlated positively with body mass index and smoking status and negatively with high-density lipoprotein cholesterol. The unadjusted hazard ratio for the primary end point was 1.48 (95% CI, 1.26 to 1.74) in a comparison of top and bottom thirds for CRP, falling to 1.36 (95% CI, 1.15 to 1.61) with adjustment for established predictors and body mass index. Similar results were obtained for other end points or when results were examined separately by history of vascular disease. However, baseline CRP added minimally to risk prediction beyond conventional predictors and did not relate to the magnitude of pravastatin benefit. Conclusions-Elevated CRP minimally enhances cardiovascular disease prediction beyond established vascular risk factors and does not predict response to statin therapy in elderly subjects at risk. These data suggest that CRP has limited clinical value in cardiovascular disease risk stratification or predicting response to statin therapy in elderly people.

Revue / Journal Title

Circulation    ISSN  0009-7322   CODEN CIRCAZ 

Source / Source

2007, vol. 115, no8, pp. 981-989 [9 page(s) (article)] (31 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1950) (Revue)

Mots-clés anglais / English Keywords

Vascular disease

;

Nervous system diseases

;

Central nervous system disease

;

Cerebral disorder

;

Cerebrovascular disease

;

Statin derivative

;

Enzyme inhibitor

;

Enzyme

;

Oxidoreductases

;

Hydroxymethylglutaryl-CoA reductase

;

Human

;

Cardiovascular disease

;

Antilipemic agent

;

Inflammation

;

Forecasting

;

Risk factor

;

Elderly

;

Pravastatin

;

C reactive protein

;

Stroke

;

Coronary heart disease

;

Cardiovascular disease

;

Mots-clés français / French Keywords

Inhibiteur de l'HMG-CoA reductase

;

Vaisseau sanguin pathologie

;

Système nerveux pathologie

;

Système nerveux central pathologie

;

Encéphale pathologie

;

Cérébrovasculaire pathologie

;

Statine dérivé

;

Inhibiteur enzyme

;

Enzyme

;

Oxidoreductases

;

Hydroxymethylglutaryl-CoA reductase

;

Homme

;

Maladie cardiovasculaire

;

Hypocholestérolémiant

;

Hypolipémiant

;

Inflammation

;

Prévision

;

Facteur risque

;

Personne âgée

;

Pravastatine

;

Protéine C réactive

;

Accident cérébrovasculaire

;

Cardiopathie coronaire

;

Appareil circulatoire pathologie

;

Mots-clés espagnols / Spanish Keywords

Vaso sanguíneo patología

;

Sistema nervioso patología

;

Sistema nervosio central patología

;

Encéfalo patología

;

Vaso sanguíneo encéfalo patología

;

Statina derivado

;

Inhibidor enzima

;

Enzima

;

Oxidoreductases

;

Hydroxymethylglutaryl-CoA reductase

;

Hombre

;

Cardiovascular enfermedad

;

Hipolipemiante

;

Inflamación

;

Previsión

;

Factor riesgo

;

Anciano

;

Pravastatina

;

Proteína reactiva

;

Accidente cerebrovascular

;

Cardiopatía coronaria

;

Aparato circulatorio patología

;

Mots-clés d'auteur / Author Keywords

aged

;

cardiovascular diseases

;

forecasting

;

inflammation

;

risk factors

;

stroke

;

Localisation / Location

INIST-CNRS, Cote INIST : 5907, 35400014332192.0060

Nº notice refdoc (ud4) : 18562457



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