%0 Journal Article %J J Am Coll Cardiol %D 2007 %T Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: the Cardiovascular Health Study. %A Novaro, Gian M %A Katz, Ronit %A Aviles, Ronnier J %A Gottdiener, John S %A Cushman, Mary %A Psaty, Bruce M %A Otto, Catherine M %A Griffin, Brian P %K Aged %K Aged, 80 and over %K Aortic Valve %K Aortic Valve Stenosis %K C-Reactive Protein %K Calcinosis %K Cardiovascular Diseases %K Cohort Studies %K Disease Progression %K Female %K Follow-Up Studies %K Heart Valve Diseases %K Humans %K Male %K Risk Factors %X

OBJECTIVES: The purpose of this study was to examine the relationship between C-reactive protein (CRP) and calcific aortic valve disease in a large, randomly selected, population-based cohort.

BACKGROUND: The pathobiology of calcific aortic stenosis involves an active inflammatory, atheromatous, osteogenic process. Elevations in CRP, a measure of systemic inflammation, have been associated with aortic stenosis.

METHODS: Two-dimensional and Doppler echocardiography and CRP measurement were performed at baseline in 5,621 participants in the Cardiovascular Health Study. Multivariable analysis was used to identify CRP as a predictor of baseline and incident aortic stenosis.

RESULTS: At a mean echocardiographic follow-up of 5 years, 9% of subjects with aortic sclerosis progressed to some degree of aortic stenosis. Increasing age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.16; p < 0.001) and male gender (OR 3.05, 95% CI 1.76 to 5.27; p < 0.001) were related to risk of incident aortic stenosis, whereas increasing height (OR 0.96, 95% CI 0.94 to 0.99; p = 0.013) and African-American ethnicity conveyed a lower risk (OR 0.49, 95% CI 0.25 to 0.95; p = 0.035). C-reactive protein, treated as a continuous variable, was not associated with baseline aortic stenosis, progression to aortic sclerosis (adjusted OR 0.93, 95% CI 0.85 to 1.02; p = 0.107), or progression to aortic stenosis (adjusted OR 0.85, 95% CI 0.70 to 1.03; p = 0.092).

CONCLUSIONS: In this large population-based cohort, approximately 9% of subjects with aortic sclerosis progressed to aortic stenosis over a 5-year follow-up period. There was no association between CRP levels and the presence of calcific aortic-valve disease or incident aortic stenosis. C-reactive protein appears to be a poor predictor of subclinical calcific aortic-valve disease.

%B J Am Coll Cardiol %V 50 %P 1992-8 %8 2007 Nov 13 %G eng %N 20 %1 https://www.ncbi.nlm.nih.gov/pubmed/17996566?dopt=Abstract %R 10.1016/j.jacc.2007.07.064