The association of c-reactive protein, serum amyloid a and fibrinogen withprevalent coronary heart disease - baseline findings of the PAIS project

Recent data suggest that infections, inflammation and the immune system are involved in the process of atherosclerosis. The aim of the present study w as to analyze the association of coronary heart disease (CHD) with three in flammation markers, C-reactive protein (CRP), serum amyloid-A (SAA) and pla sma fibrinogen. The cross-sectional study included 1400 men aged 45-74 year s, who participated in a cardiovascular risk factor survey in Finland in 19 97. Participants with prevalent CHD had markedly higher CRP, SAA and fibrin ogen levels than participants without CHD. In logistic regression models, t he age, smoking, serum cholesterol and systolic blood pressure adjusted odd s ratios (2nd, 3rd and 4th quartile as compared with the Ist quartile) of C HD increased gradually with increasing quartile of CRP (1.90, 2.27, 2.64), SAA (1.68, 1.83, 2.41), and fibrinogen (1.60, 1.95, 2.14). The associations weakened somewhat after further adjustment for indicators of obesity, part icularly waist hip-ratio. CRP, SAA and fibrinogen levels were markedly lowe r among CHD patients using cholesterol-lowering medication as compared to n on-users. In conclusion, CRP, SAA and fibrinogen, which are markers of infl ammation, were positively and significantly associated with prevalent CHD. Central obesity needs to be considered as a confounding factor in the obser ved associations. These findings support the hypothesis that cholesterol-lo wering drugs have an anti-inflammatory effect. (C) 2001 Elsevier Science Ir eland Ltd. All rights reserved.