Predictive value of high sensitivity C-reactive protein in three-vessel disease patients with and without type 2 diabetes
Authors' conclusion
Elevated hs-CRP is an independent prognostic factor for long-term outcomes of MACCE in TVD patients with type 2 diabetes but not in those without type 2 diabetes. Compared to traditional risk factors, hs-CRP improved the risk prediction of adverse cardiovascular events in TVD patients with type 2 diabetes.
Study context
- Population
- Patients with three-vessel disease (TVD), with (n = 1040, 38%) and without (n = 1694, 62%) type 2 diabetes mellitus (DM)
- Participants
- 2,734 patients
- Exposure
- High high-sensitivity C-reactive protein (hs-CRP) vs low hs-CRP, by type 2 DM status
- Outcome
- MACCE:
- Major adverse cardiac
- Cerebrovascular events
- Follow-up
- Median 2.4 years
Methodological detailsmultivariable Cox regression
- Multivariable Cox regression
Main finding
As reported in the abstract
MACCE, diabetic subgroup
Adjusted hazard ratio (95% CI)P value
High hs-CRPvs Low hs-CRPT2D
1.51(1.09–2.10)
P = 0.013Between High hs-CRP and Low hs-CRPnon-diabetic; comparable
0.93(0.71–1.22)
P = 0.613Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause death, diabetic subgroup | HR 1.63 (95% CI 0.58–4.58) | P = 0.349 | |
| Diabetic vs non-diabetic: MACCE and all-cause deathDiabeticvs Non-diabeticMACCE | aHR 1.17 (95% CI 1.01–1.35) | P = 0.031 | |
| Diabetic vs non-diabetic: MACCE and all-cause deathDiabeticvs Non-diabeticAll-cause death | HR 1.82 (95% CI 1.07–3.11) | P = 0.026 | |
| 0.20.5125Ratio (log scale) |
Added prediction of hs-CRP to baseline model for major adverse cardiac and cerebrovascular events (MACCE), diabetic subgroup
- Net reclassification improvement (NRI)
- 0.2074, p = 0.001
- Integrated discrimination improvement (IDI)
- 0.0086, p = 0.003
Original publication
Predictive value of high sensitivity C-reactive protein in three-vessel disease patients with and without type 2 diabetes. Cardiovasc Diabetol. Published 20 April 2023. doi:10.
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