Abstract P286: C-Reactive Protein, Inflammation, and Incident Venous Thrombosis: Reasons for Geographic and Racial Differences in Stroke (REGARDS)
Background: Inflammation is associated with increased risk of atherothrombosis. While C-reactive protein (CRP), a widely used biomarker of inflammation, is higher in the presence of several risk factors for venous thromboembolism (VTE), the role of CRP in predicting risk of VTE remains controversial. We examined the associations of circulating CRP and other biomarkers of inflammation with incident VTE in a large multi-ethnic population.
Methods: REGARDS recruited 30,239 participants in their homes across the continental US between 2003-07; by design 55% were female, 41% black, and 56% lived in the southeast. CRP, white blood cell count (WBC), platelet count, and serum albumin were measured in baseline samples of REGARDS. CRP was log-transformed to normalize the distribution; back transformed means are presented. Cox models were used to calculate the association of biomarkers with VTE accounting for VTE risk factors; albumin was modeled per SD lower value.
Results: There were 268 incident VTE events over 4.6 years of follow-up. Mean CRP was higher, and platelet count and albumin lower, in those with incident VTE compared to those without incident VTE (CRP: 2.8 vs. 2.2 mg/l; platelet count: 238 vs. 225 x109 cells/l; and albumin; 4.1 vs. 4.2 g/dl) (all p-values <0.05)); there were no differences in WBC. In the table, in minimally adjusted models, higher CRP and lower albumin, but not WBC or platelet count, was positively associated with VTE. After further adjustment for VTE risk factors, CRP and albumin remained associated with VTE.
Conclusion: Higher CRP and lower albumin are associated with increased risk for VTE, while white cell count and platelet count were not.These data may reflect inherent differences in the biology related to inflammation and VTE, and suggest that CRP and albumin may be risk factors for VTE.
- © 2013 by American Heart Association, Inc.