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American Journal of Epidemiology Vol. 144, No. 6: 537-547
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Relation of C-Reactive Protein and Coronary Heart Disease in the MRFIT Nested Case-Control Study
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
2Department of Pathology, University of Vermont Burlington, VT
3Multiple Risk Factor Intervention Group Coordinating Center Minneapolis, MN
4London School of Hygiene & Tropical Medicine London, United Kingdom
Reprint requests to Dr. Lewis H. Kuller, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA 15261.
The authors measured the relation between C-reactive protein, 
1 acid glycoprotein and albumin, an acute phase protein, and subsequent risk of myocardial infarction and coronary heart disease death in a nested case-control study among the Multiple Risk Factor Intervention Trial (MRFIT) participants. There were 98 myocardial infarction cases, 148 coronary heart disease deaths, and 491 controls. The cases and controls were followed for up to 17 years for deaths and 6–7 years for myocardial infarction cases and controls. There was a significant association between available distribution of C-reactive protein and subsequent coronary heart disease mortality. For smokers at baseline, the risk of coronary heart disease deaths in quartile 4 of C-reactive protein as compared with quartile 1 was 4.3 (95% confidence interval 1.74–10.8). The association persisted when adjusted for characteristics related to smoking and smoking cessation during the trial and to pulmonary function. There was no relation between 1 acid glycoprotein and either myocardial infarction or coronary heart disease death. Albumin was inversely related to coronary heart disease death only for deaths that occurred between 7 and 13 years after baseline, consistent with previous MRFIT analyses. This is the first prospective study in "healthy but high risk individuals" to document the relation between C-reactive protein and coronary heart disease mortality. Am J Epidemiol 996; 144: 537–47.
acute phase proteins; albumins; coronary disease; C-reactive protein; orosomucoid; smoking
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P.-Y. Liu, Y.-H. Li, W.-C. Tsai, T.-H. Chao, L.-M. Tsai, H.-L. Wu, and J.-H. Chen Prognostic value and the changes of plasma levels of secretory type II phospholipase A2 in patients with coronary artery disease undergoing percutaneous coronary intervention Eur. Heart J., October 2, 2003; 24(20): 1824 - 1832. [Abstract] [Full Text] [PDF]
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M. P. Reilly, M. L. Wolfe, A. R. Localio, and D. J. Rader C-Reactive Protein and Coronary Artery Calcification: The Study of Inherited Risk of Coronary Atherosclerosis (SIRCA) Arterioscler. Thromb. Vasc. Biol., October 1, 2003; 23(10): 1851 - 1856. [Abstract] [Full Text] [PDF]
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T. B. Ledue and N. Rifai Preanalytic and Analytic Sources of Variations in C-reactive Protein Measurement: Implications for Cardiovascular Disease Risk Assessment Clin. Chem., August 1, 2003; 49(8): 1258 - 1271. [Abstract] [Full Text] [PDF]
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E. C. Suarez Joint Effect of Hostility and Severity of Depressive Symptoms on Plasma Interleukin-6 Concentration Psychosom Med, July 1, 2003; 65(4): 523 - 527. [Abstract] [Full Text] [PDF]
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G. Luc, J.-M. Bard, I. Juhan-Vague, J. Ferrieres, A. Evans, P. Amouyel, D. Arveiler, J.-C. Fruchart, and P. Ducimetiere C-Reactive Protein, Interleukin-6, and Fibrinogen as Predictors of Coronary Heart Disease: The PRIME Study Arterioscler. Thromb. Vasc. Biol., July 1, 2003; 23(7): 1255 - 1261. [Abstract] [Full Text] [PDF]
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J. M. Fernandez-Real and W. Ricart Insulin Resistance and Chronic Cardiovascular Inflammatory Syndrome Endocr. Rev., June 1, 2003; 24(3): 278 - 301. [Abstract] [Full Text] [PDF]
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H.P. Kopp, C.W. Kopp, A. Festa, K. Krzyzanowska, S. Kriwanek, E. Minar, R. Roka, and G. Schernthaner Impact of Weight Loss on Inflammatory Proteins and Their Association With the Insulin Resistance Syndrome in Morbidly Obese Patients Arterioscler. Thromb. Vasc. Biol., June 1, 2003; 23(6): 1042 - 1047. [Abstract] [Full Text] [PDF]
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G. D. Slade, E. M. Ghezzi, G. Heiss, J. D. Beck, E. Riche, and S. Offenbacher Relationship Between Periodontal Disease and C-Reactive Protein Among Adults in the Atherosclerosis Risk in Communities Study Arch Intern Med, May 26, 2003; 163(10): 1172 - 1179. [Abstract] [Full Text] [PDF]
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D. Rothenbacher, A. Hoffmeister, H. Brenner, and W. Koenig Physical Activity, Coronary Heart Disease, and Inflammatory Response Arch Intern Med, May 26, 2003; 163(10): 1200 - 1205. [Abstract] [Full Text] [PDF]
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S. M. Boekholdt, W. R.P. Agema, R. J.G. Peters, A. H. Zwinderman, E. E. van der Wall, P. H. Reitsma, J. J.P. Kastelein, and J. W. Jukema Variants of Toll-Like Receptor 4 Modify the Efficacy of Statin Therapy and the Risk of Cardiovascular Events Circulation, May 20, 2003; 107(19): 2416 - 2421. [Abstract] [Full Text] [PDF]
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J.-M. Fernandez-Real, M. Broch, J. Vendrell, and W. Ricart Insulin Resistance, Inflammation, and Serum Fatty Acid Composition Diabetes Care, May 1, 2003; 26(5): 1362 - 1368. [Abstract] [Full Text] [PDF]
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M. Danner, S. V. Kasl, J. L. Abramson, and V. Vaccarino Association Between Depression and Elevated C-Reactive Protein Psychosom Med, May 1, 2003; 65(3): 347 - 356. [Abstract] [Full Text] [PDF]
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 P. G. Vlachoyiannopoulos, P. G. Kanellopoulos, J. P. A. Ioannidis, M. G. Tektonidou, I. Mastorakou, and H. M. Moutsopoulos Atherosclerosis in premenopausal women with antiphospholipid syndrome and systemic lupus erythematosus: a controlled study Rheumatology, May 1, 2003; 42(5): 645 - 651. [Abstract] [Full Text] [PDF]
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 M. Schillinger, M. Exner, W. Mlekusch, M. Haumer, H. Rumpold, R. Ahmadi, S. Sabeti, O. Wagner, and E. Minar Endovascular Revascularization Below the Knee: 6-month Results and Predictive Value of C-reactive Protein Level Radiology, May 1, 2003; 227(2): 419 - 425. [Abstract] [Full Text] [PDF]
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M. Schillinger, M. Exner, W. Mlekusch, H. Rumpold, R. Ahmadi, S. Sabeti, W. Lang, O. Wagner, and E. Minar Acute-Phase Response after Stent Implantation in the Carotid Artery: Association with 6-month In-Stent Restenosis Radiology, May 1, 2003; 227(2): 516 - 521. [Abstract] [Full Text] [PDF]
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A. D. Pradhan, N. R. Cook, J. E. Buring, J. E. Manson, and P. M. Ridker C-Reactive Protein Is Independently Associated With Fasting Insulin in Nondiabetic Women Arterioscler. Thromb. Vasc. Biol., April 1, 2003; 23(4): 650 - 655. [Abstract] [Full Text] [PDF]
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G. J. Blake and P. M. Ridker C-reactive protein and other inflammatory risk markers in acute coronary syndromes J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 37S - 42S. [Abstract] [Full Text] [PDF]
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 M. A. Zimmerman, C. H. Selzman, C. Cothren, A. C. Sorensen, C. D. Raeburn, and A. H. Harken Diagnostic Implications of C-Reactive Protein Arch Surg, February 1, 2003; 138(2): 220 - 224. [Abstract] [Full Text] [PDF]
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 C. R. Isasi, R. J. Deckelbaum, R. P. Tracy, T. J. Starc, L. Berglund, and S. Shea Physical Fitness and C-Reactive Protein Level in Children and Young Adults: The Columbia University BioMarkers Study Pediatrics, February 1, 2003; 111(2): 332 - 338. [Abstract] [Full Text] [PDF]
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P. M Ridker Clinical Application of C-Reactive Protein for Cardiovascular Disease Detection and Prevention Circulation, January 28, 2003; 107(3): 363 - 369. [Full Text] [PDF]
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T. A. Pearson, G. A. Mensah, R. W. Alexander, J. L. Anderson, R. O. Cannon III, M. Criqui, Y. Y. Fadl, S. P. Fortmann, Y. Hong, G. L. Myers, et al. Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health Practice: A Statement for Healthcare Professionals From the Centers for Disease Control and Prevention and the American Heart Association Circulation, January 28, 2003; 107(3): 499 - 511. [Full Text] [PDF]
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M. S. Beattie, M. G. Shlipak, H. Liu, W. S. Browner, N. B. Schiller, and M. A. Whooley C-Reactive Protein and Ischemia in Users and Nonusers of {beta}-Blockers and Statins: Data From the Heart and Soul Study Circulation, January 21, 2003; 107(2): 245 - 250. [Abstract] [Full Text] [PDF]
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L. Djousse, K. J. Rothman, L. A. Cupples, D. Levy, and R. C. Ellison Serum Albumin and Risk of Myocardial Infarction and All-Cause Mortality in the Framingham Offspring Study Circulation, December 3, 2002; 106(23): 2919 - 2924. [Abstract] [Full Text] [PDF]
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M. E. Bertrand, M. L. Simoons, K. A.A. Fox, L. C. Wallentin, C. W. Hamm, E. McFadden, P. J. De Feyter, G. Specchia, and W. Ruzyllo Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation Eur. Heart J., December 1, 2002; 23(23): 1809 - 1840. [Full Text] [PDF]
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