Elevated CRP ≥2 mg/L affects nearly 50% of cardiology outpatients, with age, obesity (OR~2.9), and LDL-C increasing risk, while lipid-lowering therapy reduces it (OR 0.562).
What is the prevalence and what are the independent risk factors for elevated CRP in patients attending cardiology outpatient clinics?
Elevated CRP (≥2 mg/L) is highly prevalent in cardiology outpatients, affecting nearly half of patients, with obesity and LDL-C as key modifiable risk factors, while lipid-lowering therapy is associated with lower risk.
Absolute Event Rate: 0% vs 0%
Abstract Background CRP is an established residual CVD risk factor, however the knowledge of real-life prevalence, cut-off point values over which the risk is increased, risk factors, and management is inconsistent and lacking. Purpose To investigate the prevalence of elevated CRP in real-life settings and the risk factors that are independently associated with inflammation. Methods In the STAR (Specialist Care Patients)-Lp(a) study we prospectively enrolled consecutive subjects (n=2436) referred to 2 outpatient cardiology clinics. 'Patients' for the current analysis were defined as those with established CVD or with 2 cardiovascular risk factors, the remaining were qualified as 'healthy' participants. Results Finally, we included 1936 pts (79.5%; aged 65.4±12, F: 69.8%, mean CRP: 2.47±2.2, mean BMI: 28.4±5.1 and mean CAC Score: 310.5±637) and 500 healthy individuals (aged 51.9±15, F: 70.4%, mean CRP: 2.01±1.8, mean BMI: 25.8±4.6 and mean CAC Score: 76.1±241). The prevalence of elevated CRP ≥2 mg/L or 3 mg/L among patients was 49.9 and 0.92%, and in healthy individuals 38.3% and 16.2%, respectively. In patients the largest differences between those with CRP 1, 1-3, and 3 mg/L were for female gender (from 54.7 to 74.5%; p0.001), BMI (from mean 27.5 to 29.9 kg/m²; p0.001), dyslipidemia (34.2 to 20.1%; p=0.002), mean creatinine (from 0.81 to 0.89 µmol/L; p0.01), CAC score (from 389.9 to 279.6, p=0.041) and contraction abnormalities (0 to 14.4%, p0.001). For healthy individuals the largest differences were observed for BMI (24.8 - 27.9 kg/m²; p0.001), mean Lp(a) (33.9 – 18.9 mg/dl; p=0.002), mean glucose (100.3 - 88.3 mg/dl, p0.001), and contraction abnormalities (from 0 to 11.1%, p0.001). Comparing CRP for those with 2 and ≥2 mg/L, the largest differences for patients were again for female gender, BMI/obesity, statin therapy (53.2 vs 46.1%, p=0.001), creatinine level (0.83 vs 0.89, p=0.001), and contraction abnormalities. Age (50.2 vs 54.6), female gender (45.4 vs 71.5%), BMI and obesity (9.8 vs 26.3%), CAC score (44.3 vs 127.1) and contraction abnormalities significantly differed CRP groups for healthy individuals. In patients the independent predictors of elevated CRP ≥2 mg/L are age, obesity (OR 2.867), homocysteine, LDL-C, gout and rheumatoid arthritis, while lipid lowering therapy (OR 0.562) and iron level are associated with the significant lower risk (Table 1). In healthy individuals only age, obesity (OR 3.126) and non-HDL-C independently increase this risk, and iron level is associated with the CRP elevation risk reduction (Table 2). Conclusions The prevalence of elevated CRP ≥2 mg/L in generally healthy population and patients is high and may affect even every second patient. In real-life population of individuals at CVD risk from the outpatients cardiology clinics, age, obesity and LDL/non-HDL are mostly responsible for CRP increase, and LLT and iron level are associated with the significantly lower chance of increased CRP.Table 1. Table 2.
Banach et al. (Sat,) reported a other. Elevated CRP ≥2 mg/L affects nearly 50% of cardiology outpatients, with age, obesity (OR~2.9), and LDL-C increasing risk, while lipid-lowering therapy reduces it (OR 0.562).