Genetically Elevated C-Reactive Protein and Ischemic Vascular Disease

In a study of four cohorts of patients from Denmark, the subjects were typed for four single-nucleotide polymorphisms in the gene for C-reactive protein (CRP). The resulting genotypes were correlated with an increase in CRP levels of up to 64%, a result predicting significantly increased risks of is...

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Published inThe New England journal of medicine Vol. 359; no. 18; pp. 1897 - 1908
Main Authors Zacho, Jeppe, Tybjærg-Hansen, Anne, Jensen, Jan Skov, Grande, Peer, Sillesen, Henrik, Nordestgaard, Børge G
Format Journal Article
LanguageEnglish
Published Boston, MA Massachusetts Medical Society 30.10.2008
Subjects
Online AccessGet full text
ISSN0028-4793
1533-4406
1533-4406
DOI10.1056/NEJMoa0707402

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Abstract In a study of four cohorts of patients from Denmark, the subjects were typed for four single-nucleotide polymorphisms in the gene for C-reactive protein (CRP). The resulting genotypes were correlated with an increase in CRP levels of up to 64%, a result predicting significantly increased risks of ischemic heart disease and ischemic cerebrovascular disease. However, no such increase in risk was observed, a result suggesting that the known association between CRP levels and vascular risk is not causal. Four cohorts of patients were typed for four single-nucleotide polymorphisms in the gene for C-reactive protein (CRP). Although the resulting genotypes were correlated with an increase in CRP levels of up to 64%, no increase in risk of ischemic heart disease or ischemic cerebrovascular disease was observed, suggesting that the association between CRP levels and vascular risk is not causal. Elevated plasma levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. 1 – 5 However, whether CRP is simply a marker for ischemic vascular disease or whether elevated CRP levels actually contribute directly to causing such disorders is presently unknown. This question has clinical importance, since several drugs that specifically lower CRP levels are being developed, 6 with the ultimate aim of preventing ischemic vascular disease. The random assortment of genes that occurs during gamete formation provides a relatively unbiased method of assessing whether risk factors that have a genetic component are in fact . . .
AbstractList Elevated levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. We tested whether this is a causal association. We studied 10,276 persons from a general population cohort, including 1786 in whom ischemic heart disease developed and 741 in whom ischemic cerebrovascular disease developed. We examined another 31,992 persons from a cross-sectional general population study, of whom 2521 had ischemic heart disease and 1483 had ischemic cerebrovascular disease. Finally, we compared 2238 patients with ischemic heart disease with 4474 control subjects and 612 patients with ischemic cerebrovascular disease with 1224 control subjects. We measured levels of high-sensitivity CRP and conducted genotyping for four CRP polymorphisms and two apolipoprotein E polymorphisms. The risk of ischemic heart disease and ischemic cerebrovascular disease was increased by a factor of 1.6 and 1.3, respectively, in persons who had CRP levels above 3 mg per liter, as compared with persons who had CRP levels below 1 mg per liter. Genotype combinations of the four CRP polymorphisms were associated with an increase in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease. Polymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease. However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease.
Background Elevated levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. We tested whether this is a causal association. Methods We studied 10,276 persons from a general population cohort, including 1786 in whom ischemic heart disease developed and 741 in whom ischemic cerebrovascular disease developed. We examined another 31,992 persons from a cross-sectional general population study, of whom 2521 had ischemic heart disease and 1483 had ischemic cerebrovascular disease. Finally, we compared 2238 patients with ischemic heart disease with 4474 control subjects and 612 patients with ischemic cerebrovascular disease with 1224 control subjects. We measured levels of high-sensitivity CRP and conducted genotyping for four CRP polymorphisms and two apolipoprotein E polymorphisms. Results The risk of ischemic heart disease and ischemic cerebrovascular disease was increased by a factor of 1.6 and 1.3, respectively, in persons who had CRP levels above 3 mg per liter, as compared with persons who had CRP levels below 1 mg per liter. Genotype combinations of the four CRP polymorphisms were associated with an increase in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease. Conclusions Polymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease. However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease.
Elevated levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. We tested whether this is a causal association.BACKGROUNDElevated levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. We tested whether this is a causal association.We studied 10,276 persons from a general population cohort, including 1786 in whom ischemic heart disease developed and 741 in whom ischemic cerebrovascular disease developed. We examined another 31,992 persons from a cross-sectional general population study, of whom 2521 had ischemic heart disease and 1483 had ischemic cerebrovascular disease. Finally, we compared 2238 patients with ischemic heart disease with 4474 control subjects and 612 patients with ischemic cerebrovascular disease with 1224 control subjects. We measured levels of high-sensitivity CRP and conducted genotyping for four CRP polymorphisms and two apolipoprotein E polymorphisms.METHODSWe studied 10,276 persons from a general population cohort, including 1786 in whom ischemic heart disease developed and 741 in whom ischemic cerebrovascular disease developed. We examined another 31,992 persons from a cross-sectional general population study, of whom 2521 had ischemic heart disease and 1483 had ischemic cerebrovascular disease. Finally, we compared 2238 patients with ischemic heart disease with 4474 control subjects and 612 patients with ischemic cerebrovascular disease with 1224 control subjects. We measured levels of high-sensitivity CRP and conducted genotyping for four CRP polymorphisms and two apolipoprotein E polymorphisms.The risk of ischemic heart disease and ischemic cerebrovascular disease was increased by a factor of 1.6 and 1.3, respectively, in persons who had CRP levels above 3 mg per liter, as compared with persons who had CRP levels below 1 mg per liter. Genotype combinations of the four CRP polymorphisms were associated with an increase in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease.RESULTSThe risk of ischemic heart disease and ischemic cerebrovascular disease was increased by a factor of 1.6 and 1.3, respectively, in persons who had CRP levels above 3 mg per liter, as compared with persons who had CRP levels below 1 mg per liter. Genotype combinations of the four CRP polymorphisms were associated with an increase in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease.Polymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease. However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease.CONCLUSIONSPolymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease. However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease.
In a study of four cohorts of patients from Denmark, the subjects were typed for four single-nucleotide polymorphisms in the gene for C-reactive protein (CRP). The resulting genotypes were correlated with an increase in CRP levels of up to 64%, a result predicting significantly increased risks of ischemic heart disease and ischemic cerebrovascular disease. However, no such increase in risk was observed, a result suggesting that the known association between CRP levels and vascular risk is not causal. Four cohorts of patients were typed for four single-nucleotide polymorphisms in the gene for C-reactive protein (CRP). Although the resulting genotypes were correlated with an increase in CRP levels of up to 64%, no increase in risk of ischemic heart disease or ischemic cerebrovascular disease was observed, suggesting that the association between CRP levels and vascular risk is not causal. Elevated plasma levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. 1 – 5 However, whether CRP is simply a marker for ischemic vascular disease or whether elevated CRP levels actually contribute directly to causing such disorders is presently unknown. This question has clinical importance, since several drugs that specifically lower CRP levels are being developed, 6 with the ultimate aim of preventing ischemic vascular disease. The random assortment of genes that occurs during gamete formation provides a relatively unbiased method of assessing whether risk factors that have a genetic component are in fact . . .
Author Tybjærg-Hansen, Anne
Nordestgaard, Børge G
Zacho, Jeppe
Jensen, Jan Skov
Sillesen, Henrik
Grande, Peer
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– sequence: 3
  givenname: Jan Skov
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  fullname: Jensen, Jan Skov
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  surname: Nordestgaard
  fullname: Nordestgaard, Børge G
BackLink http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20811071$$DView record in Pascal Francis
https://www.ncbi.nlm.nih.gov/pubmed/18971492$$D View this record in MEDLINE/PubMed
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CODEN NEJMAG
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Issue 18
Keywords Medicine
Vascular disease
Acute phase protein
Ischemia
Cardiovascular disease
Genetics
C reactive protein
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2008 Massachusetts Medical Society
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Snippet In a study of four cohorts of patients from Denmark, the subjects were typed for four single-nucleotide polymorphisms in the gene for C-reactive protein (CRP)....
Elevated levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. We tested...
Background Elevated levels of C-reactive protein (CRP) are associated with increased risks of ischemic heart disease and ischemic cerebrovascular disease. We...
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StartPage 1897
SubjectTerms Atherosclerosis - blood
Biological and medical sciences
Biomarkers - blood
Blood tests
C-Reactive Protein - analysis
C-Reactive Protein - genetics
Cardiovascular disease
Causality
Cerebrovascular Disorders - blood
Cerebrovascular Disorders - genetics
Cohort Studies
Cross-Sectional Studies
Female
General aspects
Genetic Predisposition to Disease
Genotype & phenotype
Humans
Male
Medical sciences
Myocardial Ischemia - blood
Myocardial Ischemia - genetics
Polymorphism, Genetic
Proteins
Risk Factors
Title Genetically Elevated C-Reactive Protein and Ischemic Vascular Disease
URI http://dx.doi.org/10.1056/NEJMoa0707402
https://www.ncbi.nlm.nih.gov/pubmed/18971492
https://www.proquest.com/docview/223926349
https://www.proquest.com/docview/69725207
Volume 359
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