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C-Reactive Protein, Fibrin D-Dimer, and Risk of Ischemic Heart Disease *

Background— There is increasing interest in the predictive value of C-reactive protein (CRP) and fibrin D-dimer in the prediction of ischemic heart disease (IHD). We assessed their joint and independent associations with IHD in a large combined analysis of 2 population cohorts.

Methods and Results— Men aged 49 to 66 years from the general populations of Caerphilly and Speedwell were studied between 1982 and 1988 and re-examined for new IHD events at fixed intervals of {approx}105 months (Caerphilly) and 75 months (Speedwell). 3213 men had CRP and D-dimer measured at baseline and 351 (11%) had a new IHD event. Mean levels of CRP and D-dimer were significantly higher among men in whom IHD developed. The relative odds of IHD in men in the top 20% of the distribution of CRP was 2.97 (95% CI, 2.04, 4.32) and for D-dimer was 2.40 (95% CI, 1.69, 3.40); CRP and D-dimer had additive effects on risk of IHD. Multivariate analysis reduced the size of the relative odds, which remained significant for D-dimer.

Conclusions— Both inflammatory and thrombogenic markers are important (and potentially additive) predictors of coronary risk.

We assessed the associations of C-reactive protein and fibrin D-dimer in the prediction of ischemic heart disease in the Caerphilly and Speedwell cohorts of 3213 men aged 49 to 66 years. Both C-reactive protein and D-dimer were significantly associated with risk, indicating that inflammatory and thrombogenic markers are potentially additive predictors.

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As with any procedure, there could be pain or other substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.

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Published on 12-13-2007