Heart Care Info - Heart Disease Prevention & Treatment

Markers of Inflammation, Metabolic Risk Factors, and Incident Heart Failure in American Indians: The Strong Heart Study

A Barac, H Wang, NM Shara... - The Journal of ..., 2012 - Wiley Online Library1. From the Washington Hospital Center, Washington, DC; 1 the Med Star Health Research Institute, Hyattsville, MD; 2 the Georgetown and Howard Universities Center for Clinical and Translational Sciences, Washington, DC; 3 the Federico II University Hospital, Naples, ...

Systemic inflammation has been associated with HF in different populations,6,19,20 and inflammatory markers may be involved directly, or as a marker of underlying conditions, in the progression from obesity and MS to LV dysfunction and HF. In the SHS cohort, elevated CRP concentrations showed a modest association with HF that was attenuated after adjustment for cardiovascular risk factors. These results are in agreement with previous SHS findings that identified high median CRP concentrations compared with other populations, as well as limited value of CRP in predicting cardiovascular events in diabetic patients.21 The high prevalence of diabetes in this population has been proposed as a main factor for the observed differences. In the present study, we also analyzed the role of elevated CRP in those with MS alone, excluding individuals with diabetes, and showed a trend towards increased HF risk in patients with MS who also had elevated CRP levels. These results are in agreement with other reports6,19,20 of increased HF risk with elevated CRP in populations without or with low prevalence of diabetes. When we extended the analysis to the diabetic population, we found that elevated CRP levels were associated with further increase in incident HF risk in diabetic patients without albuminuria, but not in diabetics with albuminuria. Our results emphasize the dynamic relationship between subclinical inflammation, MS, and overt diabetes, and suggest that the role of inflammation may be more important at intermediate levels of disease (such as MS and diabetes without albuminuria) rather than at either extreme.