C-Reactive Protein Predicts Future Arterial and Cardiovascular Events in Patients With Symptomatic Peripheral Arterial Disease

• Published in: Vascular and endovascular surgery 2008-08, Vol.42 (4), p.341-347
• Main Authors: Hogh, Annette L., Joensen, Jette, Lindholt, Jes S., Jacobsen, Martin R., Ostergaard, Lars
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers - blood; C-Reactive Protein - analysis; Cardiovascular Diseases - blood; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - therapy; Disease Progression; Female; Humans; Male; Medical sciences; Middle Aged; Peripheral Vascular Diseases - blood; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - mortality; Peripheral Vascular Diseases - therapy; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; Risk Assessment; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tobacco, tobacco smoking; Toxicology; Up-Regulation; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/1538574408316138

High-sensitivity C-reactive protein is associated with increased risk of cardiovascular events. Consequently, the predictive value of this protein in patients with symptomatic peripheral arterial disease was examined. In all, 452 patients with symptomatic peripheral arterial disease had high-sensitivity C-reactive protein measured at baseline (mean follow-up = 2.1 ± 1.4 years). Events were defined as primary (death, amputation, or peripheral revascularization) or secondary (lower limb thrombosis, myocardial infarction, or stroke).The level of high-sensitivity C-reactive protein was significantly higher among those dying (P = .04), those who needed amputation (P = .01), and those developing an overall secondary endpoint (P = .02). By receiver-operating characteristic curve analysis, the optimal cutoff point was constantly approximately 10 to 20 mg/L with a sensitivity and specificity of 56% to 63% and 54% to 56%, respectively. Baseline levels of high-sensitivity C-reactive protein are associated with future arterial events in symptomatic peripheral arterial disease patients but cannot stand alone as a predictive tool.