This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: 24/10/1957    most recent 01.ATV.0000141842.27810.a9v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lowe, G.D.O. Articles by Ben-Shlomo, Y. Search for Related Content PubMed PubMed Citation Articles by Lowe, G.D.O. Articles by Ben-Shlomo, Y.

(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

This article has been cited by other articles:

				P.E. Morange, C. Bickel, V. Nicaud, R. Schnabel, H.J. Rupprecht, D. Peetz, K.J. Lackner, F. Cambien, S. Blankenberg, L. Tiret, et al. Haemostatic Factors and the Risk of Cardiovascular Death in Patients With Coronary Artery Disease: The AtheroGene Study Arterioscler. Thromb. Vasc. Biol., December 1, 2006; 26(12): 2793 - 2799. [Abstract] [Full Text] [PDF]

				A. W. Zieske, R. P. Tracy, C. A. McMahan, E. E. Herderick, S. Homma, G. T. Malcom, H. C. McGill Jr, J. P. Strong, and for the Pathobiological Determinants of Atheroscle Elevated Serum C-Reactive Protein Levels and Advanced Atherosclerosis in Youth Arterioscler. Thromb. Vasc. Biol., June 1, 2005; 25(6): 1237 - 1243. [Abstract] [Full Text] [PDF]

				M. Cushman Leukocyte Count in Vascular Risk Prediction Arch Intern Med, March 14, 2005; 165(5): 487 - 488. [Full Text] [PDF]