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High-Sensitivity C-Reactive Protein and Coronary Heart Disease Mortality in Patients With Type 2 Diabetes

A 7-year follow-up study

¹ Department of Medicine, University of Turku, Turku, Finland
² Department of Health and Functional Capacity, National Public Health Institute, Turku, Finland
³ Department of Medicine, University of Kuopio, Kuopio, Finland

Address correspondence and reprint requests to Dr. Minna Soinio, Department of Medicine, Turku University Central Hospital, P.O. Box 52, FIN-20521 Turku, Finland. E-mail: minna.soinio{at}tyks.fi

OBJECTIVE—To investigate in a follow-up study whether high-sensitivity C-reactive protein (hs-CRP) predicts coronary heart disease (CHD) events in subjects with type 2 diabetes.

RESEARCH DESIGN AND METHODS—The original study population consisted of 1,059 patients with type 2 diabetes (age 45–64 years). Mean duration of diabetes was 8 years. CRP values were available from 1,045 subjects, of whom 878 were free of myocardial infarction (MI) at baseline. CHD mortality and the incidence of nonfatal MI were assessed in a 7-year follow-up.

RESULTS—Altogether, 157 patients died from CHD and 254 had a nonfatal or fatal CHD event. Patients with hs-CRP >3 mg/l had a higher risk for CHD death than patients with hs-CRP 3 mg/l (19.8 and 12.9%, respectively, P = 0.004). In Cox regression analysis, patients with high hs-CRP had a relative risk of 1.72 for CHD death even after the adjustment for confounding factors (P = 0.002). Among subjects who were free from MI at baseline, those with a high hs-CRP level had relative risks of 1.83 (P = 0.003) and 1.84 (P = 0.004) for CHD death in univariate and multivariate analyses, respectively.

CONCLUSIONS—In this large cohort of type 2 diabetic patients, hs-CRP was an independent risk factor for CHD deaths.

Abbreviations: CHD, coronary heart disease • CRP, C-reactive protein • hs-CRP, high-sensitivity CRP • MI, myocardial infarction

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