on August 12, 2004
Published online before print August 12, 2004, doi: 10.1161/01.ATV.0000141842.27810.a9
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Submitted on January 30, 2004
Accepted on July 12, 2004
C-Reactive Protein, Fibrin D-Dimer, and Risk of Ischemic Heart Disease. The Caerphilly and Speedwell Studies
G. D.O. Lowe *;
From the Department of Medicine (G.D.O.L., A.R.), University of Glasgow, Scotland; the Department of Epidemiology and Public Health (P.M.S., D.B.), University of Wales College of Medicine, UK; the Department of Epidemiology and Public Health (J.W.G.Y.), Queen’s University, Belfast, Ireland; and the Department of Public Health (Y.B.-S.), University of Bristol, UK.
* To whom correspondence should be addressed. E-mail: gdl1j{at}clinmed.gla.ac.uk.
Background--There is increasing interest in the predictive value of C-reactive protein (CRP) and fibrin D-dimer in the prediction of ischemic heart disease (IHD). We assessed their joint and independent associations with IHD in a large combined analysis of 2 population cohorts.
Methods and Results--Men aged 49 to 66 years from the general populations of Caerphilly and Speedwell were studied between 1982 and 1988 and re-examined for new IHD events at fixed intervals of 
105 months (Caerphilly) and 75 months (Speedwell). 3213 men had CRP and D-dimer measured at baseline and 351 (11%) had a new IHD event. Mean levels of CRP and D-dimer were significantly higher among men in whom IHD developed. The relative odds of IHD in men in the top 20% of the distribution of CRP was 2.97 (95% CI, 2.04, 4.32) and for D-dimer was 2.40 (95% CI, 1.69, 3.40); CRP and D-dimer had additive effects on risk of IHD. Multivariate analysis reduced the size of the relative odds, which remained significant.
Conclusions--Both inflammatory and thrombogenic markers are important (and potentially additive) predictors of coronary risk.
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