Abstract 1011: Coronary Artery Calcification is More Strongly Associated With Hard Coronary Events Than High-Sensitive C-Reactive Protein in the General Population: Data From the Heinz Nixdorf Recall Study
Background: High sensitive C-reactive protein (hsCRP) and coronary artery calcium (CAC) are both associated with impaired outcome in persons at risk of cardiovascular events. However, their predictive values have not been directly compared in a large randomly selected population-based cohort.
Methods: HsCRP, CAC and Framingham risk score (FRS) variables were measured in 3969 persons (aged 59±8 yrs, 53% women) without known CAD from the Heinz Nixdorf Recall Study. Subjects with hsCRP>1.0mg/dL were excluded. Subjects were followed for 5 years for the occurrence of coronary death and non-fatal myocardial infarction. The predictive values of hsCRP and CAC in addition to FRS and FRS-categories were assessed.
Results: Crude and FRS-adjusted cumulative risks of events in the hsCRP and CAC score categories are shown in table 1⇓. Adding hsCRP to FRS categories slightly increased the area under the ROC curve (AuC) from 0.666 to 0.689 (p=0.046). Adding the CAC score to the combination of hsCRP and FRS categories further improved the AuC to 0.758 (p=0.001). Adding CAC to FRS categories increased the AuC from 0.666 to 0.748 (p=0.0002). Adding hsCRP to the combination of CAC and FRS-categories did not improve the AuC much, i.e. to 0.758 (p=0.15).
Conclusion: HsCRP and CAC are both associated with coronary events independent of traditional FRS-categories in the general population. This association appears to be stronger for CAC than for hsCRP.