© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
C-Reactive Protein in Offspring Is Associated With the Occurrence of Myocardial Infarction in First-Degree Relatives
From Unita’ di Aterosclerosi e Trombosi, IRCCS "Casa Sollievo della Sofferenza (CSS)," S Giovanni Rotondo (M.M., G.C., D.C., G.V., E.G.), and Istituto di Medicina Interna e Geriatria, Università di Palermo (G.D.M.), Palermo, Italy.
Correspondence and reprint requests to Maurizio Margaglione, MD, Unità di Aterosclerosi e Trombosi, IRCCS "Casa Sollievo della Sofferenza," viale Cappuccini, San Giovanni Rotondo (FG) 71013, Italy. E-mail ate.tro{at}operapadrepio.it
Abstract—The relevance of
elevated levels of C-reactive protein (CRP) in
cardiovascular disease is gaining increasing
recognition. A family history of coronary artery disease is a
major determinant of coronary artery disease in the offspring.
In a cohort of 1048 individuals without clinical evidence of
atherosclerosis, we investigated the relationships
between CRP levels and a family history of myocardial infarction. We
measured CRP, fibrinogen, plasminogen activator
inhibitor-1, total cholesterol,
triglycerides, and some genetic polymorphisms:
plasminogen activator inhibitor-1
(4G/5G), fibrinogen (Bß-chain G
A-455), and
angiotensin-converting enzyme insertion/deletion (I/D).
Clinical data were collected by a World Health Organization–modified
questionnaire for cardiovascular disease. When compared
with subjects without first-degree relatives who had suffered a
myocardial infarction (n=867), subjects with such first-degree
relatives (n=181) were older (P=0.001), more often
hypertensive (P<0.001), and homozygous for the 4G
allele (4G/4G) of the plasminogen activator
inhibitor-1 gene (P=0.003). In addition,
they had a higher body mass index (P=0.036), raised
plasma fibrinogen (P<0.007) and total
cholesterol (P<0.001) concentrations, and
CRP levels >0.33 mg/L (P=0.005). In a multiple logistic
regression analysis, age (odds ratio [OR] 1.03, 95%
confidence interval [95% CI] 1.01 to 1.05), total
cholesterol (OR 1.35, 95% CI 1.11 to 1.65),
plasminogen activator inhibitor-1
4G/4G (OR 1.72, 95% CI 1.20 to 2.45), and CRP levels >0.33 mg/L (OR
1.75, 95% CI 1.05 to 2.91) were all independently associated with a
positive family history of myocardial infarction. We therefore conclude
that raised levels of CRP independently identify the offspring of
patients with a myocardial infarction.
Key Words: myocardial infarction • risk factors • thrombosis
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