High-sensitivity C-reactive protein predicts mortality but not stroke: The Northern Manhattan Study

M. S V Elkind, J. M. Luna, Y. P. Moon, K. M. Liu, S. L. Spitalnik, M. C. Paik, Ralph L Sacco

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Abstract

OBJECTIVE:: To determine whether high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) predict stroke, vascular events, and mortality in a prospective cohort study. BACKGROUND:: Markers of inflammation have been associated with risk of myocardial infarction (MI). Their association with stroke is controversial. METHODS:: The Northern Manhattan Study includes a stroke-free community-based cohort study in participants aged ≥40 years (median follow-up 7.9 years). hsCRP and SAA were measured using nephelometry. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of markers with risk of ischemic stroke and other outcomes after adjusting for demographics and risk factors. RESULTS:: hsCRP measurements were available in 2,240 participants (mean age 68.9 ± 10.1 years; 64.2% women; 18.8% white, 23.5% black, and 55.1% Hispanic). The median hsCRP was 2.5 mg/L. Compared with those with hsCRP <1 mg/L, those with hsCRP >3 mg/L were at increased risk of ischemic stroke in a model adjusted for demographics (HR = 1.60, 95% CI 1.06-2.41), but the effect was attenuated after adjusting for other risk factors (adjusted HR = 1.20, 95% CI 0.78-1.86). hsCRP >3 mg/L was associated with risk of MI (adjusted HR = 1.70, 95% CI 1.04-2.77) and death (adjusted HR = 1.55, 95% CI 1.23-1.96). SAA was not associated with stroke risk. CONCLUSION:: In this multiethnic cohort, high-sensitivity C-reactive protein (hsCRP) was not associated with ischemic stroke, but was modestly associated with myocardial infarction and mortality. The value of hsCRP and serum amyloid A may depend on population characteristics such as age and other risk factors.

Original languageEnglish
Pages (from-to)1300-1307
Number of pages8
JournalNeurology
Volume73
Issue number16
DOIs
StatePublished - Dec 24 2009

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C-Reactive Protein
Stroke
Serum Amyloid A Protein
Mortality
Confidence Intervals
Myocardial Infarction
Cohort Studies
Demography
Nephelometry and Turbidimetry
Population Characteristics
Hispanic Americans
Proportional Hazards Models
Blood Vessels
Prospective Studies
Inflammation

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Elkind, M. S. V., Luna, J. M., Moon, Y. P., Liu, K. M., Spitalnik, S. L., Paik, M. C., & Sacco, R. L. (2009). High-sensitivity C-reactive protein predicts mortality but not stroke: The Northern Manhattan Study. Neurology, 73(16), 1300-1307. https://doi.org/10.1212/WNL.0b013e3181bd10bc

High-sensitivity C-reactive protein predicts mortality but not stroke : The Northern Manhattan Study. / Elkind, M. S V; Luna, J. M.; Moon, Y. P.; Liu, K. M.; Spitalnik, S. L.; Paik, M. C.; Sacco, Ralph L.

In: Neurology, Vol. 73, No. 16, 24.12.2009, p. 1300-1307.

Research output: Contribution to journalArticle

Elkind, MSV, Luna, JM, Moon, YP, Liu, KM, Spitalnik, SL, Paik, MC & Sacco, RL 2009, 'High-sensitivity C-reactive protein predicts mortality but not stroke: The Northern Manhattan Study', Neurology, vol. 73, no. 16, pp. 1300-1307. https://doi.org/10.1212/WNL.0b013e3181bd10bc
Elkind, M. S V ; Luna, J. M. ; Moon, Y. P. ; Liu, K. M. ; Spitalnik, S. L. ; Paik, M. C. ; Sacco, Ralph L. / High-sensitivity C-reactive protein predicts mortality but not stroke : The Northern Manhattan Study. In: Neurology. 2009 ; Vol. 73, No. 16. pp. 1300-1307.
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abstract = "OBJECTIVE:: To determine whether high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) predict stroke, vascular events, and mortality in a prospective cohort study. BACKGROUND:: Markers of inflammation have been associated with risk of myocardial infarction (MI). Their association with stroke is controversial. METHODS:: The Northern Manhattan Study includes a stroke-free community-based cohort study in participants aged ≥40 years (median follow-up 7.9 years). hsCRP and SAA were measured using nephelometry. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95{\%} confidence intervals (CI) for the association of markers with risk of ischemic stroke and other outcomes after adjusting for demographics and risk factors. RESULTS:: hsCRP measurements were available in 2,240 participants (mean age 68.9 ± 10.1 years; 64.2{\%} women; 18.8{\%} white, 23.5{\%} black, and 55.1{\%} Hispanic). The median hsCRP was 2.5 mg/L. Compared with those with hsCRP <1 mg/L, those with hsCRP >3 mg/L were at increased risk of ischemic stroke in a model adjusted for demographics (HR = 1.60, 95{\%} CI 1.06-2.41), but the effect was attenuated after adjusting for other risk factors (adjusted HR = 1.20, 95{\%} CI 0.78-1.86). hsCRP >3 mg/L was associated with risk of MI (adjusted HR = 1.70, 95{\%} CI 1.04-2.77) and death (adjusted HR = 1.55, 95{\%} CI 1.23-1.96). SAA was not associated with stroke risk. CONCLUSION:: In this multiethnic cohort, high-sensitivity C-reactive protein (hsCRP) was not associated with ischemic stroke, but was modestly associated with myocardial infarction and mortality. The value of hsCRP and serum amyloid A may depend on population characteristics such as age and other risk factors.",
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AU - Elkind, M. S V

AU - Luna, J. M.

AU - Moon, Y. P.

AU - Liu, K. M.

AU - Spitalnik, S. L.

AU - Paik, M. C.

AU - Sacco, Ralph L

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N2 - OBJECTIVE:: To determine whether high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) predict stroke, vascular events, and mortality in a prospective cohort study. BACKGROUND:: Markers of inflammation have been associated with risk of myocardial infarction (MI). Their association with stroke is controversial. METHODS:: The Northern Manhattan Study includes a stroke-free community-based cohort study in participants aged ≥40 years (median follow-up 7.9 years). hsCRP and SAA were measured using nephelometry. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of markers with risk of ischemic stroke and other outcomes after adjusting for demographics and risk factors. RESULTS:: hsCRP measurements were available in 2,240 participants (mean age 68.9 ± 10.1 years; 64.2% women; 18.8% white, 23.5% black, and 55.1% Hispanic). The median hsCRP was 2.5 mg/L. Compared with those with hsCRP <1 mg/L, those with hsCRP >3 mg/L were at increased risk of ischemic stroke in a model adjusted for demographics (HR = 1.60, 95% CI 1.06-2.41), but the effect was attenuated after adjusting for other risk factors (adjusted HR = 1.20, 95% CI 0.78-1.86). hsCRP >3 mg/L was associated with risk of MI (adjusted HR = 1.70, 95% CI 1.04-2.77) and death (adjusted HR = 1.55, 95% CI 1.23-1.96). SAA was not associated with stroke risk. CONCLUSION:: In this multiethnic cohort, high-sensitivity C-reactive protein (hsCRP) was not associated with ischemic stroke, but was modestly associated with myocardial infarction and mortality. The value of hsCRP and serum amyloid A may depend on population characteristics such as age and other risk factors.

AB - OBJECTIVE:: To determine whether high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) predict stroke, vascular events, and mortality in a prospective cohort study. BACKGROUND:: Markers of inflammation have been associated with risk of myocardial infarction (MI). Their association with stroke is controversial. METHODS:: The Northern Manhattan Study includes a stroke-free community-based cohort study in participants aged ≥40 years (median follow-up 7.9 years). hsCRP and SAA were measured using nephelometry. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of markers with risk of ischemic stroke and other outcomes after adjusting for demographics and risk factors. RESULTS:: hsCRP measurements were available in 2,240 participants (mean age 68.9 ± 10.1 years; 64.2% women; 18.8% white, 23.5% black, and 55.1% Hispanic). The median hsCRP was 2.5 mg/L. Compared with those with hsCRP <1 mg/L, those with hsCRP >3 mg/L were at increased risk of ischemic stroke in a model adjusted for demographics (HR = 1.60, 95% CI 1.06-2.41), but the effect was attenuated after adjusting for other risk factors (adjusted HR = 1.20, 95% CI 0.78-1.86). hsCRP >3 mg/L was associated with risk of MI (adjusted HR = 1.70, 95% CI 1.04-2.77) and death (adjusted HR = 1.55, 95% CI 1.23-1.96). SAA was not associated with stroke risk. CONCLUSION:: In this multiethnic cohort, high-sensitivity C-reactive protein (hsCRP) was not associated with ischemic stroke, but was modestly associated with myocardial infarction and mortality. The value of hsCRP and serum amyloid A may depend on population characteristics such as age and other risk factors.

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