TY - JOUR
T1 - Association between temporal changes in C-reactive protein levels and prognosis in patients with previous myocardial infarction - A report from the CHART-2 Study
AU - CHART-2 investigators
AU - Oikawa, Takuya
AU - Sakata, Yasuhiko
AU - Nochioka, Kotaro
AU - Miura, Masanobu
AU - Abe, Ruri
AU - Kasahara, Shintaro
AU - Sato, Masayuki
AU - Aoyanagi, Hajime
AU - Saga, Chiharu
AU - Ikeno, Yasuko
AU - Shiroto, Takashi
AU - Sugimura, Koichiro
AU - Takahashi, Jun
AU - Miyata, Satoshi
AU - Shimokawa, Hiroaki
N1 - Funding Information:
The Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine is supported in part by unrestricted research grants from Daiichi Sankyo Co., Ltd. (Tokyo, Japan), Bayer Yakuhin, Ltd. (Osaka, Japan), Kyowa Hakko Kirin Co., Ltd. (Tokyo, Japan), Kowa Pharmaceutical Co., Ltd. (Tokyo, Japan), Novartis Pharma K.K. (Tokyo, Japan), Dainippon Sumitomo Pharma, Co., Ltd. (Osaka, Japan), Nippon Boehringer Ingelheim Co., Ltd. (Tokyo, Japan), Astellas Pharma (Tokyo, Japan), AstraZeneca (Osaka, Japan), Chugai Pharmaceutical (Tokyo, Japan), GlaxoSmithKline (Tokyo, Japan), Mitsubishi Tanabe Pharma (Osaka, Japan), Mochida Pharmaceutical (Tokyo, Japan), MSD (Tokyo, Japan), Otsuka Pharmaceutical (Tokyo, Japan), Shionogi (Osaka, Japan) and Takeda Pharmaceutical (Tokyo, Japan). H.S. has received lecture fees from Bayer Yakuhin, Ltd. (Osaka, Japan), Daiichi Sankyo Co., Ltd. (Tokyo, Japan) and Novartis Pharma K.K. (Tokyo, Japan).
Funding Information:
This study was supported in part by the Grants-in Aid from the Ministry of Health, Labour, and Welfare , the Ministry of Education, Culture, Sports, Science and Technology and the Japan Agency for Medical Research and Development (No. 15ek0210043h0001 ), Tokyo, Japan.
Funding Information:
This study was supported in part by the Grants-in Aid from the Ministry of Health, Labour, and Welfare, the Ministry of Education, Culture, Sports, Science and Technology and the Japan Agency for Medical Research and Development (No. 15ek0210043h0001), Tokyo, Japan. We thank all the members of the Tohoku Heart Failure Association and the staff of the Departments of Cardiovascular Medicine and the Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine for their contributions (see Supplementary file).
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/10/15
Y1 - 2019/10/15
N2 - Background: Several studies have reported that C-reactive protein (CRP), an inflammatory biomarker, predicts cardiovascular events independently of low-density lipoprotein cholesterol levels. However, no study examined whether temporal changes in CRP levels are associated with clinical events in patients with previous myocardial infarction (MI). Methods and results: We examined 2184 consecutive patients with previous MI and CRP data at baseline in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) Study. During the median 6.4 years follow-up, 592 all-cause, 245 cardiovascular, and 273 non-cardiovascular deaths occurred. Patients with CRP ≥ 2.0 mg/L at baseline had significantly increased incidence of all-cause (hazard ratio (HR) 1.68, P < 0.001) and non-cardiovascular death (HR 1.86, P < 0.001), compared with those with CRP < 2.0 mg/L. Temporal changes in CRP levels were associated with prognosis; among patients with CRP ≥ 2.0 mg/L at baseline, those with CRP ≥ 2.0 mg/L at 1-year had significantly increased incidence of all-cause (HR 2.12, P < 0.001), cardiovascular (HR 2.31, P < 0.001), and non-cardiovascular death (HR 2.29, P < 0.001). Among patients with CRP < 2.0 mg/L at baseline, those with CRP ≥ 2.0 mg/L at 1-year had significantly increased incidence of all-cause (HR 1.76, P < 0.001) and cardiovascular death (HR 2.10, P = 0.001). These results remained significant after adjusted with the inverse probability of treatment weighted models using propensity sore. Furthermore, as compared with patients with CRP < 2.0 mg/L at both baseline and 1-year, those with CRP ≥ 2.0 mg/L at both baseline and 1-year had increased incidence of all-cause, cardiovascular, and non-cardiovascular death. Conclusions: These results provide the evidence that temporal increases in CRP levels are associated with increased clinical events in patients with previous MI.
AB - Background: Several studies have reported that C-reactive protein (CRP), an inflammatory biomarker, predicts cardiovascular events independently of low-density lipoprotein cholesterol levels. However, no study examined whether temporal changes in CRP levels are associated with clinical events in patients with previous myocardial infarction (MI). Methods and results: We examined 2184 consecutive patients with previous MI and CRP data at baseline in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) Study. During the median 6.4 years follow-up, 592 all-cause, 245 cardiovascular, and 273 non-cardiovascular deaths occurred. Patients with CRP ≥ 2.0 mg/L at baseline had significantly increased incidence of all-cause (hazard ratio (HR) 1.68, P < 0.001) and non-cardiovascular death (HR 1.86, P < 0.001), compared with those with CRP < 2.0 mg/L. Temporal changes in CRP levels were associated with prognosis; among patients with CRP ≥ 2.0 mg/L at baseline, those with CRP ≥ 2.0 mg/L at 1-year had significantly increased incidence of all-cause (HR 2.12, P < 0.001), cardiovascular (HR 2.31, P < 0.001), and non-cardiovascular death (HR 2.29, P < 0.001). Among patients with CRP < 2.0 mg/L at baseline, those with CRP ≥ 2.0 mg/L at 1-year had significantly increased incidence of all-cause (HR 1.76, P < 0.001) and cardiovascular death (HR 2.10, P = 0.001). These results remained significant after adjusted with the inverse probability of treatment weighted models using propensity sore. Furthermore, as compared with patients with CRP < 2.0 mg/L at both baseline and 1-year, those with CRP ≥ 2.0 mg/L at both baseline and 1-year had increased incidence of all-cause, cardiovascular, and non-cardiovascular death. Conclusions: These results provide the evidence that temporal increases in CRP levels are associated with increased clinical events in patients with previous MI.
KW - C-reactive protein
KW - Myocardial infarction
KW - Temporal change
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U2 - 10.1016/j.ijcard.2019.07.022
DO - 10.1016/j.ijcard.2019.07.022
M3 - Article
C2 - 31358306
AN - SCOPUS:85069656732
VL - 293
SP - 17
EP - 24
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -