C-reactive protein levels in patients at cardiovascular risk: EURIKA study

Julian P J Halcox, Carine Roy, Florence Tubach, José R Banegas, Jean Dallongeville, Guy De Backer, Eliseo Guallar, Ogün Sazova, Jesús Medina, Joep Perk, Philippe Gabriel Steg, Fernando Rodríguez-Artalejo, Claudio Borghi, Julian P J Halcox, Carine Roy, Florence Tubach, José R Banegas, Jean Dallongeville, Guy De Backer, Eliseo Guallar, Ogün Sazova, Jesús Medina, Joep Perk, Philippe Gabriel Steg, Fernando Rodríguez-Artalejo, Claudio Borghi

Abstract

Background: Elevated C-reactive protein (CRP) levels are associated with high cardiovascular risk, and might identify patients who could benefit from more carefully adapted risk factor management. We have assessed the prevalence of elevated CRP levels in patients with one or more traditional cardiovascular risk factors.

Methods: Data were analysed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov Identifier: NCT00882336), which included patients (aged ≥50 years) from 12 European countries with at least one traditional cardiovascular risk factor but no history of cardiovascular disease. Analysis was also carried out on the subset of patients without diabetes mellitus who were not receiving statin therapy.

Results: In the overall population, CRP levels were positively correlated with body mass index and glycated haemoglobin levels, and were negatively correlated with high-density lipoprotein cholesterol levels. CRP levels were also higher in women, those at higher traditionally estimated cardiovascular risk and those with greater numbers of metabolic syndrome markers. Among patients without diabetes mellitus who were not receiving statin therapy, approximately 30% had CRP levels ≥3 mg/L, and approximately 50% had CRP levels ≥2 mg/L, including those at intermediate levels of traditionally estimated cardiovascular risk.

Conclusions: CRP levels are elevated in a large proportion of patients with at least one cardiovascular risk factor, without diabetes mellitus who are not receiving statin therapy, suggesting a higher level of cardiovascular risk than predicted according to conventional risk estimation systems.

Trial registration: ClinicalTrials.gov Identifier: NCT00882336.

Figures

Figure 1
Figure 1
Distribution of CRP levels in the overall population. The x axis is a logarithmic scale, with absolute values indicated. The box plot underneath the graph indicates minimum, maximum, median and interquartile range.
Figure 2
Figure 2
Number of metabolic syndrome components present in patients with different CRP levels.
Figure 3
Figure 3
CRP levels according to predicted cardiovascular risk by (a) SCORE and (b) FRS, in patients without diabetes mellitus who were not receiving statin treatment.

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