The Role of High Sensitivity C-Reactive Protein and Coronary Artery Calcium as Predictors of the Long-term Prognosis in Men with Coronary Artery Disease

Purpose: Measurements of coronary artery calcium (CAC) and of high sensitivity C-reactive protein (hsCRP) are used to predict the risk of cardiovascular events in patients with coronary artery disease (CAD). The aim of our study was to investigate the hypothesis that combining the hsCRP level and CAC score can increase the predictive value of these parameters for future cardiovascular events in male patients with suspected CAD. Methods: We included 90 male patients with stable angina. We measured their serum hsCRP and CAC scores by using electron-beam computerized tomography. These baseline parameters were correlated to the clinical cardiovascular events within the follow-up period. Results: During the follow-up period of up to 50 months (median 27 months), 13 major cardiovascular events were recorded. In multivariate regression analysis, after being adjusted for conventional risk factors, hsCRP and CAC score, hsCRP level was the only independent predictor of cardiovascular events. Further analysis was performed among the four groups classified by CAC score (CAC score ≥100 or <100) and hsCRP (hsCRP ≥1 or <1 mg/l). The relative risk for the hsCRP ≥1 mg/l and CAC score ≥100 group, when compared with that for the hsCRP <1 mg/l and CAC score <100 group, showed a marked increase to 7.50 (95% confidence interval: 1.42-39.61, p=0.018) for the cardiovascular events. Conclusion: We concluded that risk stratification on the basis of both hsCRP level and CAC score might be of benefit to male patients with suspected CAD, as the combined use of these two markers allowed significantly more accurate prediction of cardiovascular events.