Prospective Study of C-Reactive Protein and the Risk of Future Cardiovascular Events Among Apparently Healthy Women

TLDR

C‑reactive protein predicts myocardial infarction and stroke risk in healthy men, but data for women are scarce. The study measured baseline CRP in 122 women who later had a first cardiovascular event and 244 matched controls over three years. Women with higher baseline CRP had a 5‑fold higher risk of any vascular event and a 7‑fold higher risk of MI or stroke, independent of other risk factors, and adding CRP improved predictive models.

Abstract

Background —C-reactive protein (CRP) predicts risk of myocardial infarction (MI) and stroke among apparently healthy men, but in women, virtually no data are available. Methods and Results —CRP was measured in baseline blood samples from 122 apparently healthy participants in the Women’s Health Study who subsequently suffered a first cardiovascular event and from 244 age- and smoking-matched control subjects who remained free of cardiovascular disease during a 3-year follow-up period. Women who developed cardiovascular events had higher baseline CRP levels than control subjects ( P =0.0001), such that those with the highest levels at baseline had a 5-fold increase in risk of any vascular event (RR=4.8; 95% CI, 2.3 to 10.1; P =0.0001) and a 7-fold increase in risk of MI or stroke (RR=7.3; 95% CI, 2.7 to 19.9; P =0.0001). Risk estimates were independent of other risk factors, and prediction models that included CRP provided a better method to predict risk than models that excluded CRP (all P values <0.01). In stratified analyses, CRP was a predictor among subgroups of women with low as well as high risk as defined by other cardiovascular risk factors. Conclusions —In these prospective data among women, CRP is a strong independent risk factor for cardiovascular disease that adds to the predictive value of risk models based on usual factors alone.