Abstract P361: C-Reactive Protein and Coronary Heart Disease Events in Obese vs. Non-Obese Individuals: The Dallas Heart Study
Background: C-reactive protein (CRP) levels are strongly associated with adiposity. Whether the association between CRP and coronary heart disease (CHD) events differs between obese and non-obese individuals is unknown.
Methods: We measured CRP and CHD outcomes in subjects ages 30-65 in the Dallas Heart Study, a multi-ethnic population based sample. After the exclusion of underweight subjects (BMI <18.5kg/m2), the cohort was stratified into obese (BMI ≥30kg/m2) and non-obese (BMI<30kg/m2) groups. The primary outcome included CHD death, myocardial infarction, coronary revascularization, and hospitalization for unstable angina. The BMI group-specific associations between CRP (>3 vs. ≤3mg/L) and CHD outcomes were assessed using the log-rank test and in Cox proportional hazard models adjusted for traditional risk factors.
Results: The study cohort comprised of 2658 individuals with a mean age of 44 years, including 57% women and 50% blacks. Obese (n=1224) subjects compared with non-obese (n=1434) had a higher prevalence of traditional risk factors and a greater proportion of elevated CRP (65.7% vs. 30.9%, p<0.001). Higher CRP levels were not associated with incident CHD events (n=74) in obese individuals, but were strongly associated in non-obese (Figure), with a statistically significant interaction (p-interaction=0.048). These findings persisted after multivariable adjustment for age, sex, race and traditional risk factors (obese: HR= 1.02, 95% CI 0.49-2.1, p=0.96; non-obese: HR= 2.31, 95% CI 1.13-4.74, p=0.02) and were similar when restricting the endpoint to CHD death and MI.
Conclusions: In a large population-based sample, increased CRP was not associated with incident CHD events in obese individuals, suggesting that its utility as a CHD risk marker may be limited among those with increased adiposity.
- © 2013 by American Heart Association, Inc.