TY - JOUR
T1 - High-sensitivity C-reactive protein and all-cause mortality in four diverse populations
T2 - The CRONICAS Cohort Study
AU - Bernabe-Ortiz, Antonio
AU - Carrillo-Larco, Rodrigo M.
AU - Gilman, Robert H.
AU - Smeeth, Liam
AU - Checkley, William
AU - Miranda, J. Jaime
N1 - Funding Information:
Data Statement. Data for analyses (dataset and dictionary) is available at Figshare. Bernabe-Ortiz, Antonio; Miranda, J. Jaime (2021): CRP and mortality. figshare. Dataset. https://doi.org/10.6084/m9.figshare.17129321.v1. The original CRONICAS Cohort Study was funded in whole with Federal Funds from the United States National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under contract No. HHSN268200900033C. RMC-L is funded by a Wellcome Trust International Training Fellowship (214185/Z/18/Z). The funders had no role in the preparation of the manuscript, or the decision to publish.
Publisher Copyright:
© 2021
PY - 2022/3
Y1 - 2022/3
N2 - Purpose: To assess the association between all-cause mortality and hs-CRP, based mainly on the cumulative burden approach. Methods: Cohort study with adults ≥35 years from general population, using hs-CRP at two timepoints: at baseline and 30 months later to establish different exposures: change over time, cumulative, and weighted cumulative hs-CRP. The outcome was all-cause mortality assessed 7 years later. Cox models were generated to quantify the association. Results: Data from 3,119 participants (mean age 55.6 years, and 51.2% females), were analyzed. During follow-up, 164 (5.6%) deaths occurred over 20,314.5 person-years, indicating an overall mortality rate of 8.1 per 1,000 person-years. In multivariable model, hs-CRP at baseline was associated with high risk of mortality (HR = 1.77; 95%CI: 1.28–2.46). Similarly, hs-CRP change over time (HR = 2.50; 95%CI: 1.46–4.29), as well as cumulative and weighted cumulative hs-CRP (HR = 2.05; 95%CI: 1.31–3.20) were associated with greater risk of all-cause mortality. The weighted cumulative hs-CRP had the best goodness-of-fit for mortality prediction. Conclusions: In this cohort across diverse geographical low-resource settings, high levels of hs-CRP were strongly associated with all-cause mortality. Two measurements of hs-CRP are better than one to predict mortality, and the weighted cumulative approach had the best prognostic fit.
AB - Purpose: To assess the association between all-cause mortality and hs-CRP, based mainly on the cumulative burden approach. Methods: Cohort study with adults ≥35 years from general population, using hs-CRP at two timepoints: at baseline and 30 months later to establish different exposures: change over time, cumulative, and weighted cumulative hs-CRP. The outcome was all-cause mortality assessed 7 years later. Cox models were generated to quantify the association. Results: Data from 3,119 participants (mean age 55.6 years, and 51.2% females), were analyzed. During follow-up, 164 (5.6%) deaths occurred over 20,314.5 person-years, indicating an overall mortality rate of 8.1 per 1,000 person-years. In multivariable model, hs-CRP at baseline was associated with high risk of mortality (HR = 1.77; 95%CI: 1.28–2.46). Similarly, hs-CRP change over time (HR = 2.50; 95%CI: 1.46–4.29), as well as cumulative and weighted cumulative hs-CRP (HR = 2.05; 95%CI: 1.31–3.20) were associated with greater risk of all-cause mortality. The weighted cumulative hs-CRP had the best goodness-of-fit for mortality prediction. Conclusions: In this cohort across diverse geographical low-resource settings, high levels of hs-CRP were strongly associated with all-cause mortality. Two measurements of hs-CRP are better than one to predict mortality, and the weighted cumulative approach had the best prognostic fit.
KW - C-reactive protein
KW - Cohort
KW - Inflammation
KW - Mortality
KW - Peru
UR - http://www.scopus.com/inward/record.url?scp=85122148042&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85122148042&partnerID=8YFLogxK
U2 - 10.1016/j.annepidem.2021.12.007
DO - 10.1016/j.annepidem.2021.12.007
M3 - Article
C2 - 34923118
AN - SCOPUS:85122148042
SN - 1047-2797
VL - 67
SP - 13
EP - 18
JO - Annals of epidemiology
JF - Annals of epidemiology
ER -