Is CRP level a causal factor in cardiovascular disease?

January 01, 0001

Is CRP level a causal factor in cardiovascular disease?

C reactive protein (CRP) can be used as a marker for cardiovascular risk on some populations. This international group of investigators looked at four genetic variants (rs3093077, rs1205, rs1130864, rs1800947) affecting level CRP and the risk of cardiovascular disease. They performed a mendelian randomization meta-analysis of individual enrollee data from 47 epidemiological studies spanning 15 countries (n=194 418). They looked at four gene variants.

The researchers found: "CRP variants were each associated with up to 30% per allele difference in concentration of C reactive protein (P<10-34) and were unrelated to other risk factors. Risk ratios for coronary heart disease per additional copy of an allele associated with raised C reactive protein were 0.93 for rs3093077, 1.00 for rs1205, 0.98 for rs1130864, and 0.99 for rs1800947. In a combined analysis, the risk ratio for coronary heart disease was 1.00 per 1 SD higher genetically raised natural log (ln) concentration of C reactive protein. The genetic findings were discordant with the risk ratio observed for coronary heart disease of 1.33 per 1 SD higher circulating ln concentration of C reactive protein in prospective studies."

The researchers concluded: "Human genetic data indicate that C reactive protein concentration itself is unlikely to be even a modest causal factor in coronary heart disease."

This genetic analysis suggests that C reactive protein, while a marker for cardiovascular risk, is not a cause of cardiovascular disease in and of itself.

For the full abstract, click here.

BMJ 342:d548, 15 February 2011
© 2011 BMJ Publishing Group Ltd.
Association between C reactive protein and coronary heart disease: mendelian randomisation analysis based on individual participant data. C Reactive Protein Coronary Heart Disease Genetics Collaboration (CCGC). Correspondence to: [email protected]

Category: K. Circulatory. Keywords: c reacrive protein, CRP, cardiovascular disease, genetic variants, polymorphisms, meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 1 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.