Nader Rifai, PhD; Julie E. Buring, ScD; I-Min Lee, MBBS, ScD; JoAnn E. Manson, MD; Paul M Ridker, MD
Disclosure: Dr. Ridker is named as a co-inventor on patents related to the use of inflammatory biomarkers in cardiovascular disease.
Grant Support: By the National Heart, Lung, and Blood Institute (HL 58755); an Established Investigator Award from the American Heart Association (Dr. Ridker); and a Distinguished Clinical Scientist Award from the Doris Duke Charitable Foundation (Dr. Ridker).
Requests for Single Reprints: Paul M Ridker, MD, Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215; e-mail, email@example.com.
Current Author Addresses: Dr. Rifai: Department of Laboratory Medicine, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115.
Drs. Buring, Lee, Manson, and Ridker: Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215.
Author Contributions: Conception and design: N. Rifai, P.M. Ridker.
Analysis and interpretation of the data: N. Rifai, J.E. Manson, P.M. Ridker.
Drafting of the article: N. Rifai, P.M. Ridker.
Critical revision of the article for important intellectual content: N. Rifai, J.E. Buring, I.-M. Lee, J.E. Manson, P.M. Ridker.
Final approval of the article: N. Rifai, J.E. Buring, I.-M. Lee, J.E. Manson, P.M. Ridker.
Provision of study materials or patients: J.E. Buring, P.M. Ridker.
Statistical expertise: J.E. Manson, P.M. Ridker.
Obtaining of funding: P.M. Ridker.
Administrative, technical, or logistic support: J.E. Buring, J.E. Manson.
Collection and assembly of data: N. Rifai, I.-M. Lee, P.M. Ridker.
C-reactive protein (CRP) predicts risk for future cardiovascular events in asymptomatic individuals. However, because CRP also predicts total mortality, its specificity for vascular disease is uncertain.
To compare the predictive value of CRP for cancer and cardiovascular disease, the major determinants of mortality.
Prospective, nested case–control study.
The Women's Health Study, an ongoing prospective cohort study involving 28 345 U.S. women 45 years of age and older who were healthy at the time of enrollment.
643 women who subsequently developed cancer or had cardiovascular events; 643 age- and smoking-matched women who remained free of either disease during 58-month follow-up.
Baseline CRP levels.
Little evidence showed that increasing quartiles of baseline CRP predicted incident cancer (adjusted relative risks, 1.0, 1.2, 1.1, and 1.3; P for trend > 0.2). In contrast, increasing quartiles of baseline CRP were a strong marker of risk for future cardiovascular disease (adjusted relative risks, 1.0, 2.9, 3.4, and 5.6; P for trend < 0.001).
C-reactive protein appears to independently predict cardiovascular events but not cancer.
Rifai N, Buring JE, Lee I, Manson JE, Ridker PM. Is C-Reactive Protein Specific for Vascular Disease in Women?. Ann Intern Med. ;136:529–533. doi: 10.7326/0003-4819-136-7-200204020-00010
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Published: Ann Intern Med. 2002;136(7):529-533.
Cardiology, Coronary Risk Factors, Hematology/Oncology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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