炎症和CHD的流行病学：hs-CRP的证据课件.ppt

Epidemiology of Inflammatory Markers and CHD: Evidence for High-Sensitivity C-Reactive ProteinPaul M. Ridker, MD, MPH Beyond Cholesterol: Predicting Cardiovascular Risk In the 21st Century Total Cholesterol Distribution: CHD vs Non-CHD Population Inflammation and Atherosclerosis hs-CRP and Risk of Future MI in Apparently Healthy Men hs-CRP and Risk of Future MI: Analysis Stratified by Smoking Status hs-CRP and Risk of Future MI: Analysis Stratified by Year of Follow-up hs-CRP and Risk of Future Stroke in Apparently Healthy Men hs-CRP and Risk of Developing PVD in Apparently Healthy Men hs-CRP and Risk of Future Cardiovascular Events in Apparently Healthy Women hs-CRP and Risk of Future Cardiovascular Events in Apparently Healthy Women: Low-Risk Subgroups hs-CRP and Coronary Heart Disease in Initially Healthy Men: MONICA–Augsburg Cohort hs-CRP as a Risk Factor for Future CVD hs-CRP Adds to the Predictive Value of Total Cholesterol in Determining Risk of First MI hs-CRP Adds to Predictive Value of TC:HDL Ratio in Determining Risk of First MI hs-CRP, Lipids, and Risk of Future Coronary Events: Womens Health Study (WHS) Relative Risks for First MI for Baseline sICAM-1 260 ng/dL Predictivity of Interleukin-6 on CV Risk in Women Plasma Concentration of TNF-? and Risk of Recurrent Coronary Events Risk Factors for Future Cardiovascular Events: WHS Predictive Value of CRP and Other Inflammatory Markers: LDL 130 mg/dL Potential Mechanisms Linking CRP to Atherothrombosis Confounding by cigarette consumption Innocent bystander- Acute phase response Cytokine surrogate- IL-6, TNF-?, IL-1? Direct effects of CRP- Innate immunity- Complement activation- CAM induction Prior infection- Chlamydia, H pylori, CMV Evaluating Novel Risk Factors for CAD Consistency of prospective data Strength of association Independence of association Improve predictive value Standardized measure CRP vs hs-CRP CRP is an acute-phase protein produced by the liver in response to cytokine