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  • Title: C-reactive protein and risk of venous thromboembolism in the general population.
    Author: Zacho J, Tybjaerg-Hansen A, Nordestgaard BG.
    Journal: Arterioscler Thromb Vasc Biol; 2010 Aug; 30(8):1672-8. PubMed ID: 20466978.
    Abstract:
    OBJECTIVE: To examine the robustness of the association between C-reactive protein (CRP) levels and increased risk of venous thromboembolism (VTE) and to examine whether genetically elevated CRP levels cause VTE. METHODS AND RESULTS: In the prospective Copenhagen City Heart Study, we observed 10 388 participants for longer than 16 years, of whom 484 developed a VTE. In the cross-sectional Copenhagen General Population Study, we studied 36 616 participants, of whom 903 previously had a VTE. Levels of CRP greater than 3 mg/L versus less than 1 mg/L were associated with a 2.3- and 2.4-fold increased risk of VTE in the Copenhagen City Heart Study and the Copenhagen General Population Study, respectively. CRP levels in tertiles, quintiles, and octiles associated with a stepwise increase in VTE risk. CRP genotypes associated with an increase in plasma CRP levels up to 59% but did not associate consistently with risk of VTE in either study. The causal odds ratio for VTE for a doubling in genetically elevated CRP on instrumental variable analyses was lower than the odds ratio for VTE observed for a doubling in plasma CRP on logistic regression ([odds ratio and 95% CI] 0.80 [0.56 to 1.12] versus 1.17 [1.08 to 1.27]; P=0.04). CONCLUSIONS: We observed 47,000 participants from the general population, of whom 1387 developed VTE. Although elevated CRP levels robustly associated with increased risk of VTE, this may not necessarily be a causal association because genetically elevated CRP did not associate with VTE risk.
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