Atherosclerosis and Lipoproteins |
From the Centre for Cardiovascular Genetics (D.J.B., F.Z., L.J., H.E.M., S.E.H.) and Centre for Clinical Pharmacology (L.J., P.S., A.D.H.), BHF Laboratories at UCL, Royal Free and UCL Medical School, London, UK; Universidad Autónoma de Bucaramanga (N.S.), Bucaramanga, Colombia; Department of Medicine (A.R., G.D.O.L.), University of Glasgow, UK; and Royal Centre for Defence Medicine (M.J.W.), Selly Oak Hospital, Birmingham, UK.
Correspondence to Dr A.D. Hingorani, Centre for Clinical Pharmacology, BHF Laboratories at UCL, 5 University St, London WC1E 6JJ. E-mail a.hingorani{at}ucl.ac.uk
Objective C-reactive protein (CRP) concentrations are predictive of cardiovascular disease, and levels are heritable, in part. We identified novel polymorphisms in the CRP gene and assessed their influence on CRP level.
Methods and Results CRP was measured in 250 male army recruits before and after strenuous exercise and perioperatively in 193 coronary artery bypass graft (CABG) patients. Two novel polymorphisms were identified in the CRP gene, -717G>A in the promoter and +1444C>T in the 3'UTR. Among army recruits, CRP was higher in +1444TT homozygotes than +1444 C-allele carriers at baseline (1.04±0.38 versus 0.55±0.06, P=0.014) and at all time points after exercise (2.35±0.68 versus 1.07±0.12, 2.11±0.53 versus 0.88±0.09, and 1.77±0.44 versus 0.71±0.09, P=0.034, P=0.007, and P=0.013, at 2, 48, and 96 hours after exercise, respectively). In the CABG patients, mean CRP (mg/L) rose from 1.97±0.36 at baseline to 167.2±5.0 72 hours postoperatively. Genotype did not influence CRP at baseline; however, peak post-CABG CRP levels were higher in +1444TT homozygotes compared with +1444C-allele carriers (198±17 versus 164±5, P=0.03).
Conclusions The CRP gene +1444C>T variant influences basal and stimulated CRP level. These findings have implications both for the prediction and pathogenesis of coronary heart disease.
Key Words: genetics inflammation C-reactive protein coronary heart disease risk factors
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