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Predictive Value of CRP vs. LDL-C for Cardiovascular Events: A Comparative Analysis

This study by Ridker PM et al. published in N Engl J Med examines the predictive capabilities of C-reactive protein (CRP) and low-density lipoprotein cholesterol (LDL-C) in determining the risk of first cardiovascular events. Adjusted relative risk (RR) values indicate that high CRP combined with low LDL-C correlates with heightened cardiovascular risk. The research utilizes quintile distributions of CRP and LDL-C levels to illustrate these associations, offering insights into patient risk stratification and the importance of inflammation in cardiovascular health.

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Predictive Value of CRP vs. LDL-C for Cardiovascular Events: A Comparative Analysis

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  1. Predictive value of CRP vs LDL-C (i) Quintile of CRP (mg/L) • Ridker PM, et al. N Engl J Med 2002;347:1557-1565. < 0.49 >0.49 to 1.08 >1.08 to 2.09 >2.09 to 4.19 >4.19 p value Adjusted RR* of a first cardio-vascular event 1.0 1.4 1.6 2.0 2.3 <0.001 * relative risk adjusted for age, smoking status, the presence or absence of diabetes mellitus, blood pressure, use or nonuse of hormone replacement therapy, and treatment assignment

  2. Quintile of LDL-C (mg/dL) < 97.6 >97.6 to 115.4 >115.4 to 132.2 >132.2 to 153.9 >153.9 p value Adjusted RR* of a first cardio-vascular event 1.0 0.9 1.1 1.3 1.5 <0.001 Predictive value of CRP vs LDL-C (ii) * relative risk adjusted for age, smoking status, the presence or absence of diabetes mellitus, blood pressure, use or nonuse of hormone replacement therapy, and treatment assignment Ridker PM, et al. N Engl J Med 2002;347:1557-1565.

  3. High CRP/low LDL-C predicts high risk • Ridker PM, et al. N Engl J Med 2002;347:1557-1565. Low CRPLow LDL* Low CRPHigh LDL High CRPLow LDL High CRPHigh LDL Age-adjusted event rates per 1000 person-years 1.3 2.6 3.9 2.0 * Low and high refer to levels below and above the median values of CRP (1.52 mg/L) and LDL-C (123.7 mg/dL)

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