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首页> 外文期刊>The New England journal of medicine >C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease.
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C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease.

机译：C反应蛋白和炎症的其他循环标志物可预测冠心病。

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BACKGROUND: C-reactive protein is an inflammatory marker believed to be of value in the prediction of coronary events. We report data from a large study of C-reactive protein and other circulating inflammatory markers, as well as updated meta-analyses, to evaluate their relevance to the prediction of coronary heart disease. METHODS: Measurements were made in samples obtained at base line from up to 2459 patients who had a nonfatal myocardial infarction or died of coronary heart disease during the study and from up to 3969 controls without a coronary heart disease event in the Reykjavik prospective study of 18,569 participants. Measurements were made in paired samples obtained an average of 12 years apart from 379 of these participants in order to quantify within-person fluctuations in inflammatory marker levels. RESULTS: The long-term stability of C-reactive protein values (within-person correlation coefficient, 0.59; 95 percent confidence interval, 0.52 to 0.66) was similar to that of both blood pressure and total serum cholesterol. After adjustment for base-line values for established risk factors, the odds ratio for coronary heart disease was 1.45 (95 percent confidence interval, 1.25 to 1.68) in a comparison of participants in the top third of the group with respect to base-line C-reactive protein values with those in the bottom third, and similar overall findings were observed in an updated meta-analysis involving a total of 7068 patients with coronary heart disease. By comparison, the odds ratios in the Reykjavik Study for coronary heart disease were somewhat weaker for the erythrocyte sedimentation rate (1.30; 95 percent confidence interval, 1.13 to 1.51) and the von Willebrand factor concentration (1.11; 95 percent confidence interval, 0.97 to 1.27) but generally stronger for established risk factors, such as an increased total cholesterol concentration (2.35; 95 percent confidence interval, 2.03 to 2.74) and cigarette smoking (1.87; 95 percent confidence interval, 1.62 to 2.16). CONCLUSIONS: C-reactive protein is a relatively moderate predictor of coronary heart disease. Recommendations regarding its use in predicting the likelihood of coronary heart disease may need to be reviewed.
机译：背景：C反应蛋白是一种炎症标记，被认为在预测冠状动脉事件中具有重要价值。我们报告了一项来自大量C反应蛋白和其他循环炎症标记物研究的数据，以及更新的荟萃分析，以评估其与冠心病预测的相关性。方法：在研究期间，对基线的样本进行了测量，这些样本来自多达2459例非致命性心肌梗死或死于冠心病的患者，以及雷克雅未克前瞻性研究中18695例的多达3969名无冠心病事件的对照组。参与者。对这些样本中的379名参与者平均12年后获得的配对样本进行测量，以量化人体内炎症标志物水平的波动。结果：C反应蛋白值的长期稳定性（人际相关系数为0.59; 95％的置信区间为0.52至0.66）与血压和总血清胆固醇的相似。调整已确定的危险因素的基线值后，与基线C相比，前三名参与者的冠心病比值比为1.45（95％置信区间，1.25至1.68） -反应蛋白值与倒数第三位的蛋白值相同，并且在更新的荟萃分析中观察到相似的总体发现，该分析共涉及7068例冠心病患者。相比之下，雷克雅未克研究中冠心病的比值比在红细胞沉降率（1.30; 95％置信区间为1.13至1.51）和冯·威兰布兰德因子浓度（1.11; 95％置信区间为0.97至0.95）方面较弱。 1.27），但对于已确定的危险因素通常更强，例如增加的总胆固醇浓度（2.35; 95％的置信区间为2.03至2.74）和吸烟（1.87; 95％的置信区间为1.62至2.16）。结论：C反应蛋白是冠心病的相对中等的预测指标。关于其在预测冠心病可能性中的用途的建议可能需要审查。

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