C-reactive protein is independently associated with coronary atherosclerosis burden among octogenarians

Aim of the study: In contrast to the general population, individuals with primarily persistent elevation of inflammatory activity display a significant association between inflammatory biomarkers and atherosclerotic burden. In older individuals, immunosenescence upregulates the innate response and, by this way, may hypothetically favor the presence of this association. The aim of this study was to evaluate this hypothesis in healthy octogenarians. Methods: Participants (n = 208) aged 80 years or older, asymptomatic and without medical and laboratory evidence of chronic diseases or use of anti-inflammatory treatments were included in the study. Lipid profile and plasma C-reactive protein (CRP) were measured at baseline and cardiac computed tomography was performed within 1-week interval for measuring coronary calcium score (CCS). Results: The median plasma CRP was 1.9 mg/L (1.0-3.4) and 33% of the participants had elevated CRP defined as ≥3 mg/L. Among those with high CRP, there was an increased frequency of high CCS (≥100) as compared with their counterparts (71 vs 50%, p = 0.001). The association between CRP and CCS persisted even after adjustment for age, sex, cardiovascular risk factors and statin therapy. The area under the receiver-operating curve for CRP was 0.606 using CCS ≥100 as a binary outcome. The sensitivities for CCS ≥100 were 40 and 74% for the cutoff points of CRP ≥3 or 1 mg/L, respectively. Conclusion: The present study was able to confirm that in very elderly individuals, systemic inflammatory activity is independently associated with coronary atherosclerosis burden.