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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:1385.)
© 2008 American Heart Association, Inc.

Clinical and Population Studies

High-Sensitivity C-Reactive Protein and Coronary Heart Disease in a General Population of Japanese

The Hisayama Study

Hisatomi Arima; Michiaki Kubo; Koji Yonemoto; Yasufumi Doi; Toshiharu Ninomiya; Yumihiro Tanizaki; Jun Hata; Kiyoshi Matsumura; Mitsuo Iida; Yutaka Kiyohara

From the Department of Environmental Medicine (H.A., M.K., K.Y., T.N., Y.T., J.H., Y.K.) and the Department of Medicine and Clinical Science (Y.D., K.M., M.I.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Correspondence to Hisatomi Arima, MD, Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 Japan. E-mail harima{at}envmed.med.kyushu-u.ac.jp

Abstract

Objective— The purpose of this study was to investigate the effects of high-sensitivity C-reactive protein (hs-CRP) on the risks of coronary heart disease (CHD) in a general population of Japanese.

Methods and Results— The Hisayama study is a population-based prospective cohort study. A total of 2589 participants aged 40 years or older were followed up for 14 years. Outcomes are incident CHD (myocardial infarction, coronary revascularization, and sudden cardiac death). The median hs-CRP level was 0.43 mg/L at baseline. During the follow-up period, 129 coronary events were observed. Age- and sex-adjusted annual incidence rates of CHD rose progressively with higher hs-CRP levels: 1.6, 3.3, 4.5, and 7.4 per 1000 person-years for quartile groups defined by hs-CRP levels of <0.21, 0.21 to 0.43, 0.44 to 1.02, and >1.02 mg/L, respectively (P<0.0001 for trend). The risk of CHD in the highest quartile group was 2.98-fold (95% CI, 1.53 to 5.82) higher than that in the lowest group even after controlling for other cardiovascular risk factors.

Conclusions— hs-CRP levels were clearly associated with future CHD events in a general population of Japanese. In Japanese populations, the hs-CRP cut-off point for high-risk of future development of CHD is likely to be >1.0 mg/L, which is much lower than that for Western populations.

hs-CRP levels were clearly associated with future coronary events in a general population of Japanese. In Japanese populations, the hs-CRP cut-off point for high-risk of future development of CHD is likely to be >1.0 mg/L, which is much lower than that for Western populations.

Key Words: inflammation • C-reactive protein • coronary heart disease • prospective cohort study • general population

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