Abstract 2185: The Relative Strength of C-Reactive Protein and Lipid Levels as Predictors of Ischemic Stroke as Compared to Coronary Heart Disease
Introduction: While high-sensitivity C-reactive protein (hsCRP) and lipid levels are established risk determinants for vascular disease, the relative strength of these biomarkers for ischemic stroke as compared to coronary disease (CHD) is uncertain.
Objective: To determine the relative strength of hsCRP and lipid levels as predictors of future ischemic stroke as compared with coronary heart disease in women.
Methods: Among 15,632 initially healthy women who were followed for a 10-year period, we compared hsCRP, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoproteins A-I and B100, and lipid ratios as determinants of ischemic stroke as compared to coronary heart disease.
Results: After adjustment for age, smoking status, blood pressure, diabetes, and obesity, the hazard ratios (HRs) and 95% confidence intervals for the third versus the first tertile for future ischemic stroke as compared to CHD were 1.91 (1.13–3.21) and 2.26 (1.64–3.12) for TC, 1.72 (1.03–2.86) and 2.93 (2.04–4.21) for non-HDL-C, 0.57 (0.36–0.92) and 0.38 (0.27–0.52) for HDL-C, and 2.76 (1.51–5.05) and 1.66 (1.17–2.34) for hsCRP, respectively. Of the lipid ratios, the TC to HDL-C ratio had the largest HR for both future ischemic stroke and CHD [HR 1.95 (1.16–3.26) and 4.20 (2.79–6.32), respectively] (Figure 1⇓).
Conclusions: In this large, prospective cohort of initially healthy women, lipid levels significantly predict ischemic stroke, but with a magnitude of effect smaller than that observed for CHD. hsCRP associates more closely with ischemic stroke than CHD.