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. 2018 Dec 3;17(1):273.
doi: 10.1186/s12944-018-0923-1.

Baseline levels of serum high sensitivity C reactive protein and lipids in predicting the residual risk of cardiovascular events in Chinese population with stable coronary artery disease: a prospective cohort study

Wen Dai  1 , Ziyu Zhang  1 , Shuiping Zhao  2
Affiliations

Baseline levels of serum high sensitivity C reactive protein and lipids in predicting the residual risk of cardiovascular events in Chinese population with stable coronary artery disease: a prospective cohort study

Wen Dai et al. Lipids Health Dis. .

Abstract

Background: The contributions of inflammation, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) to the residual risk of cardiovascular events have not been determined in a large cohort of Chinese population before. This study was aimed to investigate the association of serum levels of high sensitive C reactive protein (hs-CRP), TG and HDL-C with the residual risk of cardiovascular events in patients with stable coronary artery disease (CAD).

Methods: We enrolled 4090 patients with stable CAD from 13 hospitals in China. All participants received optimal medical treatment (OMT) for stable CAD suggested by guidelines and were followed. The endpoint measures were the first occurrence of a major adverse cardiovascular event (MACE), defined as cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or unplanned coronary revascularization. Cox proportional regression analysis was conducted to identify independent predictors of MACE.

Results: We found that hs-CRP and HDL-C levels were associated with coronary lesion severity at baseline (both p < 0.001). After 3 months OMT, 91.2% (3730/4090) patients achieved the therapeutic goal for low density lipoprotein cholesterol (LDL-C) (< 1.8 mmoL/L). During a mean follow-up period of 39.5 months, 11.5% (471/4090) patients suffered MACE. In multivariate Cox proportional regression analysis, the hazard ratio for MACE was 1.17 (95% confidence interval: 1.07-1.28, p < 0.001) per standardized deviation in the log-transformed hs-CRP levels after adjustment for other traditional cardiovascular risk factors. However, baseline TG and HDL-C levels were not associated with MACE in this study.

Conclusions: Baseline hs-CRP level was an independent predictor of residual risk of cardiovascular events in Chinese population with stable CAD. However, TG and HDL-C levels were not associated with MACE.

Keywords: Coronary artery disease; High density lipoprotein cholesterol; High sensitivity-C reactive protein; Inflammation; Triglyceride.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the ethics committee review board of The Second Xiangya Hospital of Central South University. Informed written consent was obtained from all participants.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The selection process of study population
Fig. 2
Fig. 2
The adjusted cumulative event-free survival rate of the study population. There existed significant differences in the adjusted cumulative event-free survival rate among LDL-C and hs-CRP subgroups (p = 0.001).LDL-C: low density lipoprotein cholesterol, hs-CRP: high sensitivity C reactive protein; HDL-C: high density lipoprotein cholesterol; TG: triglyceride
See this image and copyright information in PMC

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