The Effect of Including C-Reactive Protein in Cardiovascular Risk Prediction Models for Women

摘要: Background: While high-sensitivity C-reactive protein (hsCRP) is an independent predictor of cardiovascular risk, global risk prediction use. Objective: To develop and compare models with without hsCRP. Design: Observational cohort study. Setting: U.S. female health professionals. Participants: Initially healthy nondiabetic women age 45 years older participating in the Women’s Health Study followed average 10 years. Measurements: Incident events (myocardial infarction, stroke, coronary revascularization, death). Results: High-sensitivity CRP made a relative contribution to at least as large that provided by total, high-density lipoprotein (HDL), low-density (LDL) cholesterol individually, but less than age, smoking, blood pressure. All measures fit improved when hsCRP was included, likelihood-based demonstrating strong preference for include With use 10-year categories 0% 5%, 5% 10%, 10% 20%, 20% or greater, more accurate included hsCRP, particularly between 20%. Among initially classified risks according Adult Treatment Panel III covariables, 21% 19%, respectively, were reclassified into categories. Although addition had minimal effect on c-statistic (a measure model discrimination) once pressure accounted for, nonetheless greater LDL, HDL cholesterol, suggesting may be insensitive evaluating models. Limitations: Data available only women. Conclusions: A includes improves classification women, among those In pressure, smoking status, much do lipid measures.