C-Reactive Protein, Fibrinogen Slightly Improve Risk Modeling
(HealthDay News) – The addition of C-reactive protein (CRP) or fibrinogen offers a modest improvement to conventional cardiovascular risk modeling, according to a study published in the Oct 4 issue of the New England Journal of Medicine.
Stephen Kaptoge, PhD, from the University of Cambridge in the U.K., and members of the Emerging Risk Factors Collaboration analyzed data from 52 prospective studies involving 246,669 participants without a history of cardiovascular disease to examine the value of assessing levels of CRP or other biomarkers.
The researchers found that the addition of high-density lipoprotein cholesterol information to a conventional prognostic model increased the C-index measure of risk discrimination by 0.005. The addition of CRP or fibrinogen information significantly increased the C-index by 0.0039 and 0.0027, respectively. These correlated with significant net reclassification improvements of 1.52% for CRP and 0.83% for fibrinogen for the predicted 10-year risk categories of "low" (<10%), "intermediate" (10–<20%), and "high" (≥20%). Among 100,000 adults aged 40 years or older, an estimated 15,025 persons would initially be classified as being at intermediate risk for a cardiovascular event using conventional risk factors. Based on current treatment guidelines, additional targeted assessment of CRP or fibrinogen levels in the 13,199 remaining intermediate risk participants could help to prevent about 30 additional cardiovascular events over 10 years.
"We estimated that under current treatment guidelines, assessment of the CRP or fibrinogen level in people at intermediate risk for a cardiovascular event could help prevent one additional event over a period of 10 years for every 400–500 people screened," the authors write.
The study was partially funded by an unrestricted educational grant from GlaxoSmithKline; several authors disclosed financial ties to pharmaceutical companies, including GlaxoSmithKline.