Prognostic value of high sensitive C-reactive protein in subjects with silent myocardial ischemia

ObjectivesThe aim of this study was to evaluate the prognostic value of high sensitive C-reactive protein (CRP) in subjects with silent myocardial ischemia (SMI).DesignIn total, 678 healthy men and women aged 55 to 75 years with no history of cardiovascular disease or stroke were included. High-sensitive CRP and 48-hour ambulatory ECG monitoring were performed. The primary endpoint was the combined endpoint of death and myocardial infarction.ResultsThe median follow-up time was 76 months. Seventy-seven subjects (11.4%) had SMI. The combined endpoint occurred in 26% of the subjects with SMI and 14% of the subjects without SMI (P = .005). SMI had a poor prognosis in the group with an elevated CRP ≥3.0 μg/mL (hazard ratio, 3.46; 95% confidence interval, 1.67-7.16; P = .001) compared with the group of subjects with SMI and a low CRP <3.0 μg/mL (hazard ratio, 1.37; 95% confidence interval, 0.63-2.98; P = .54).ConclusionsIn apparently healthy subjects, a low level of CRP <3.0 μg/mL selects a low-risk subgroup, despite the presence of SMI.