C-reactive protein in offspring is associated with the occurrence of myocardial infarction in first-degree relatives

The relevance of elevated levels of C-reactive protein (CRP) in cardiovascu lar disease is gaining increasing recognition. A family history of coronary artery disease is a major determinant of coronary artery disease in the of fspring. In a cohort of 1048 individuals without clinical evidence of ather osclerosis, we investigated the relationships between CRP levels and a fami ly history of myocardial infarction. We measured CRP, fibrinogen, plasminog en activator inhibitor-1, total cholesterol, triglycerides, and some geneti c polymorphisms: plasminogen activator inhibitor-1 (4G/5G), fibrinogen (B b eta-chain G-->A(-455)), and angiotensin-converting enzyme insertion/deletio n (I/D). Clinical data were collected by a World Health Organization-modifi ed questionnaire for cardiovascular disease, When compared with subjects wi thout first-degree relatives who had suffered a myocardial infarction (n=86 7), subjects with such first-degree relatives (n=181) were older (P=0.001), more often hypertensive (P<0.001), and homozygous for the 4G allele (4G/4G ) of the plasminogen activator inhibitor-1 gene (P=0.003). In addition, the y had a higher body mass index (P=0.036), raised plasma fibrinogen (P<0.007 ) and total cholesterol (P<0.001) concentrations, and CRP levels >0.33 mg/L (P=0.005). In a multiple logistic regression analysis, age (odds ratio [OR ] 1.03, 95% confidence interval [95% CI] 1.01 to 1.05), total cholesterol ( OR 1.35, 95% CI 1.11 to 1.65), plasminogen activator inhibitor-1 4G/4G (OR 1.72, 95% CI 1.20 to 2.45), and CRP levels >0.33 mg/L (OR 1.75, 95% CI 1.05 to 2.91) were all independently associated with a positive family history of myocardial infarction. We therefore conclude that raised levels of CRP i ndependently identify the offspring of patients with a myocardial infarctio n.