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High Confidence
Meta-AnalysisPMC Full Text2010

C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis

Emerging Risk Factors Collaboration • Lancet

Key Finding

Per 3-fold higher CRP: CHD HR 1.37 (1.27-1.48), ischaemic stroke HR 1.27 (1.15-1.40), vascular mortality HR 1.55 (1.37-1.76) after adjustment

Key Findings

  • 1CHD: HR 1.37 (95% CI 1.27-1.48) per 3-fold higher CRP after adjustment
  • 2Ischaemic stroke: HR 1.27 (95% CI 1.15-1.40) per 3-fold higher CRP
  • 3Vascular mortality: HR 1.55 (95% CI 1.37-1.76) per 3-fold higher CRP
  • 4Associations depend on conventional risk factors and inflammation markers

Original title: “C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis”

Plain English Summary

Individual participant meta-analysis of 160,309 participants across 54 prospective studies (1.31 million person-years, 27,769 outcomes) examining CRP associations with vascular and non-vascular mortality.

In-Depth Analysis

Study Details

Authors: Emerging Risk Factors Collaboration (ERFC)
Writing Committee: Kaptoge S, Di Angelantonio E, Lowe G, Pepys MB, Thompson SG, Collins R, Danesh J
Journal: Lancet, 2010 Jan 9; 375(9709):132-140
PMCID: PMC3162187

Study Population

  • •Participants: 160,309
  • •Studies: 54 prospective studies
  • •Person-years: 1.31 million
  • •Outcomes: 27,769 disease events
  • •Mean age: 60 years (SD 8)
  • •Women: 48%
  • •Median follow-up: 5.8 years
  • •Baseline CRP median: 1.72 mg/L (5th-95th: 0.25-12.4)

Key Results: Hazard Ratios per 3-fold Higher CRP

OutcomeAge/Sex AdjustedFully Adjusted
Coronary heart disease1.63 (1.51-1.76)1.37 (1.27-1.48)
Ischaemic stroke1.44 (1.32-1.57)1.27 (1.15-1.40)
Vascular mortality1.71 (1.53-1.91)1.55 (1.37-1.76)
Non-vascular mortality1.55 (1.41-1.69)1.54 (1.40-1.68)

Authors' Conclusion

"CRP concentration has continuous associations with risk of coronary heart disease, ischaemic stroke, vascular mortality, and death from several cancers and lung disease...Associations with ischaemic vascular disease depend considerably on conventional risk factors and other markers of inflammation."

Source: PMC full text (PMC3162187)

Paradigm Relevance

How this study applies to different clinical perspectives:

Standard Medical

Relevant

Conventional clinical guidelines used by most doctors

Why it matters:

Foundational evidence for CRP as cardiovascular risk stratification tool in AHA/CDC guidelines

Research Consensus

Relevant

Current scientific understanding, often ahead of guidelines

Why it matters:

Demonstrates continuous dose-response relationship; even "normal" CRP levels carry gradient of risk

Metabolic Optimization

Relevant

Proactive targets for optimal health, not just disease absence

Why it matters:

Supports monitoring CRP to assess cardiovascular protection from anti-inflammatory interventions

Study Details

Type
Meta-Analysis
Methodology
Individual participant meta-analysis. N = 160,309 participants from 54 prospective studies. 1.31 million person-years. 27,769 disease outcomes.

Evidence Quality

Grade A - Large meta-analysis. PMC3162187. Emerging Risk Factors Collaboration.

Topic

hscrpCardiovascularInflammation

Related Biomarkers

HSCRPCRP

Calculate & Evaluate on Metabolicum

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hsCRP

Evaluator

High-sensitivity inflammation marker

Original Source

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