Association of high-sensitivity C-reactive protein with fatal and non-fatal cardiovascular events in working-age people: data from the ESSE-RF study

Aim. To study the relationship of different levels of high-sensitivity C-reactive protein (hs-CRP) with cardiovascular events and assess its contribution to the development of outcomes in Russian regions.

Material and methods. The work used the data from the multicenter study ESSE-RF — a representative sample of male and female population aged 25-64 years. All participants signed informed consent. The study included 10421 people (women, 6399 (61,4%)). The cohort was followed up from 2012 to 2019 (median follow-up period, 5,5 years). A hard endpoint (cardiovascular mortality and nonfatal myocardial infarction (MI)) was determined in 187 people, while a soft endpoint (nonfatal MI, stroke, revascularization, heart failure progression and cardiovascular mortality) — in 319 people.

Results. The results showed that hs-CRP is significantly associated with the main risk factors (with the exception of low-density lipoproteins). At the same time, it was found that optimal hs-CRP level for predicting the risk of cardiovascular events (CVE) in Russian population is significantly lower than 3 mg/L, but higher than 1 mg/L (1,54/1,89 mg/dL for men and women, respectively). Adding hs-CRP to sex and age significantly improved risk prediction (AUC, 79,7; 95% CI, 77,8-81,7). At the same time, adding a wide list of confounders to hs-CRP, sex and age does not improve the model’s predictive value (AUC, 79,7; 78,2-82,1).

Conclusion. This study for the first time showed a significant independent contribution of hs-CRP to CVEs development in the Russian population, and the addition of hs-CRP to sex and age significantly increased the predictive value of model.

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