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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:1957.)
© 2004 American Heart Association, Inc.

Thrombosis

C-Reactive Protein, Fibrin D-Dimer, and Risk of Ischemic Heart Disease

The Caerphilly and Speedwell Studies

G.D.O. Lowe; P.M. Sweetnam; J.W.G. Yarnell; A. Rumley; C. Rumley; D. Bainton; Y. Ben-Shlomo

From the Department of Medicine (G.D.O.L., A.R., C.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.

Correspondence to Prof G.D.O. Lowe, University Department of Medicine, Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK. 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 for D-dimer.

Conclusions— Both inflammatory and thrombogenic markers are important (and potentially additive) predictors of coronary risk.

We assessed the associations of C-reactive protein and fibrin D-dimer in the prediction of ischemic heart disease in the Caerphilly and Speedwell cohorts of 3213 men aged 49 to 66 years. Both C-reactive protein and D-dimer were significantly associated with risk, indicating that inflammatory and thrombogenic markers are potentially additive predictors.

Key Words: coronary heart disease • coagulation • fibrin degradation products • inflammation

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