Abstract 17661: Effect of C - Reactive Protein Level on Angiographic Disease Progression and Clinical Events Among the Post Menopausal Women: Data from Women'S Angiographic Vitamin and Estrogen (wave) Study
Introduction: C-reactive protein (CRP), a marker of inflammation, is found to be associated with adverse cardiovascular outcomes. However, it is unclear that the cardiovascular risk associated with CRP is due to progressive coronary arterial narrowing or due to formation of unstable plaques. This study was designed to determine the effect of baseline CRP levels on cardiovascular events and on the progression of atherosclerotic narrowing among post menopausal women.
Methods: 423 postmenopausal women with documented angiographic stenosis between 15 -75%, were randomized in the WAVE trial to Vitamin C and E and hormone replacement therapy or placebo. For the study 320 women underwent baseline and follow up (mean= 2.8 years) angiograms. Women were stratified into four groups (quartiles) according to baseline CRP levels. The changes in lumen diameter and clinical events in each quartile were compared.
Results: Post menopausal women with baseline CRP level in the upper quartile were more likely to be diabetic and more likely to have lower HDL cholesterol and higher triglycerides. Annualized minimal and average lumen diameter change in the diseased and non-diseased segments were not significantly different between four quartiles. However, the composite outcome of death and MI as well as cardiovascular death and MI increased with an increase in CRP quartile. The difference remained significant even after adjusted for baseline differences as well as for traditional cardiovascular risk factors.
Conclusion: Among postmenopausal women with coronary atherosclerosis, higher baseline CRP was found to be associated with a higher risk of mortality and cardiovascular events but not with luminal narrowing of coronary arteries over period of 3 years. Thus, the risk associated with a higher baseline CRP is not necessarily mediated through rapid progression of atherosclerosis rather it may represent inflammatory changes in fibroatheromas which may lead to plaque rupture.
- © 2012 by American Heart Association, Inc.