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Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men

Background Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk. Methods We measured plasma C-reactive protein, a marker for systemic inflammation, i... Full description

Journal Title: The New England Journal of Medicine Apr 3, 1997, Vol.336(14), pp.973-979
Main Author: Ridker, Paul M
Other Authors: Cushman, Mary , Stampfer, Meir J , Tracy, Russell P , Hennekens, Charles H
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 00284793
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title: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men
format: Article
creator:
  • Ridker, Paul M
  • Cushman, Mary
  • Stampfer, Meir J
  • Tracy, Russell P
  • Hennekens, Charles H
subjects:
  • Adult–Pharmacology
  • Aged–Therapeutic Use
  • Aged, 80 & Over–Pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal–Therapeutic Use
  • Anti-Inflammatory Agents, Non-Steroidal–Etiology
  • Aspirin–Immunology
  • Aspirin–Prevention & Control
  • Brain Ischemia–Analysis
  • Brain Ischemia–Drug Effects
  • Brain Ischemia–Blood
  • C-Reactive Protein–Complications
  • C-Reactive Protein–Drug Therapy
  • Humans–Etiology
  • Inflammation–Immunology
  • Inflammation–Prevention & Control
  • Inflammation–Etiology
  • Male–Immunology
  • Middle Aged–Prevention & Control
  • Myocardial Infarction–Prevention & Control
  • Myocardial Infarction–Prevention & Control
  • Myocardial Infarction–Prevention & Control
  • Risk–Prevention & Control
  • Thrombophlebitis–Prevention & Control
  • Thrombophlebitis–Prevention & Control
  • Thrombophlebitis–Prevention & Control
  • Heart Attacks
  • Cardiovascular Disease
  • Proteins
  • Diet
  • Blood Clots
  • Atherosclerosis
  • Aspirin
  • Plasma
  • Stroke
  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin
  • C-Reactive Protein
ispartof: The New England Journal of Medicine, Apr 3, 1997, Vol.336(14), pp.973-979
description: Background Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk. Methods We measured plasma C-reactive protein, a marker for systemic inflammation, in 543 apparently healthy men participating in the Physicians' Health Study in whom myocardial infarction, stroke, or venous thrombosis subsequently developed, and in 543 study participants who did not report vascular disease during a follow-up period exceeding eight years. Subjects were randomly assigned to receive aspirin or placebo at the beginning of the trial. Results Base-line plasma C-reactive protein concentrations were higher among men who went on to have myocardial infarction (1.51 vs. 1.13 mg per liter, P
language: eng
source:
identifier: ISSN: 00284793
fulltext: fulltext
issn:
  • 00284793
  • 0028-4793
url: Link


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titleInflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men
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descriptionBackground Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk. Methods We measured plasma C-reactive protein, a marker for systemic inflammation, in 543 apparently healthy men participating in the Physicians' Health Study in whom myocardial infarction, stroke, or venous thrombosis subsequently developed, and in 543 study participants who did not report vascular disease during a follow-up period exceeding eight years. Subjects were randomly assigned to receive aspirin or placebo at the beginning of the trial. Results Base-line plasma C-reactive protein concentrations were higher among men who went on to have myocardial infarction (1.51 vs. 1.13 mg per liter, P<0.001) or ischemic stroke (1.38 vs. 1.13 mg per liter, P = 0.02), but not venous thrombosis (1.26 vs. 1.13 mg per liter, P = 0.34), than among men without vascular events. The men in the quartile with the highest C-reactive protein values had three times the risk of myocardial infarction (relative risk, 2.9; P<0.001) and two times the risk of ischemic stroke (relative risk, 1.9; P = 0.02) of the men in the lowest quartile. Risks were stable over long periods, were not modified by smoking, and were independent of other lipid-related and non-lipid-related risk factors. The use of aspirin was associated with significant reductions in the risk of myocardial infarction (55.7 percent reduction, P = 0.02) among men in the highest quartile but with only small, nonsignificant reductions among those in the lowest quartile (13.9 percent, P = 0.77). Conclusions The base-line plasma concentration of C-reactive protein predicts the risk of future myocardial infarction and stroke. Moreover, the reduction associated with the use of aspirin in the risk of a first myocardial infarction appears to be directly related to the level of C-reactive protein, raising the possibility that antiinflammatory agents may have clinical benefits in preventing cardiovascular disease.
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titleInflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men
descriptionBackground Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk. Methods We measured plasma C-reactive protein, a marker for systemic inflammation, in 543 apparently healthy men participating in the Physicians' Health Study in whom myocardial infarction, stroke, or venous thrombosis subsequently developed, and in 543 study participants who did not report vascular disease during a follow-up period exceeding eight years. Subjects were randomly assigned to receive aspirin or placebo at the beginning of the trial. Results Base-line plasma C-reactive protein concentrations were higher among men who went on to have myocardial infarction (1.51 vs. 1.13 mg per liter, P<0.001) or ischemic stroke (1.38 vs. 1.13 mg per liter, P = 0.02), but not venous thrombosis (1.26 vs. 1.13 mg per liter, P = 0.34), than among men without vascular events. The men in the quartile with the highest C-reactive protein values had three times the risk of myocardial infarction (relative risk, 2.9; P<0.001) and two times the risk of ischemic stroke (relative risk, 1.9; P = 0.02) of the men in the lowest quartile. Risks were stable over long periods, were not modified by smoking, and were independent of other lipid-related and non-lipid-related risk factors. The use of aspirin was associated with significant reductions in the risk of myocardial infarction (55.7 percent reduction, P = 0.02) among men in the highest quartile but with only small, nonsignificant reductions among those in the lowest quartile (13.9 percent, P = 0.77). Conclusions The base-line plasma concentration of C-reactive protein predicts the risk of future myocardial infarction and stroke. Moreover, the reduction associated with the use of aspirin in the risk of a first myocardial infarction appears to be directly related to the level of C-reactive protein, raising the possibility that antiinflammatory agents may have clinical benefits in preventing cardiovascular disease.
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7Brain Ischemia–Analysis
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abstractBackground Inflammation may be important in the pathogenesis of atherothrombosis. We studied whether inflammation increases the risk of a first thrombotic event and whether treatment with aspirin decreases the risk. Methods We measured plasma C-reactive protein, a marker for systemic inflammation, in 543 apparently healthy men participating in the Physicians' Health Study in whom myocardial infarction, stroke, or venous thrombosis subsequently developed, and in 543 study participants who did not report vascular disease during a follow-up period exceeding eight years. Subjects were randomly assigned to receive aspirin or placebo at the beginning of the trial. Results Base-line plasma C-reactive protein concentrations were higher among men who went on to have myocardial infarction (1.51 vs. 1.13 mg per liter, P<0.001) or ischemic stroke (1.38 vs. 1.13 mg per liter, P = 0.02), but not venous thrombosis (1.26 vs. 1.13 mg per liter, P = 0.34), than among men without vascular events. The men in the quartile with the highest C-reactive protein values had three times the risk of myocardial infarction (relative risk, 2.9; P<0.001) and two times the risk of ischemic stroke (relative risk, 1.9; P = 0.02) of the men in the lowest quartile. Risks were stable over long periods, were not modified by smoking, and were independent of other lipid-related and non-lipid-related risk factors. The use of aspirin was associated with significant reductions in the risk of myocardial infarction (55.7 percent reduction, P = 0.02) among men in the highest quartile but with only small, nonsignificant reductions among those in the lowest quartile (13.9 percent, P = 0.77). Conclusions The base-line plasma concentration of C-reactive protein predicts the risk of future myocardial infarction and stroke. Moreover, the reduction associated with the use of aspirin in the risk of a first myocardial infarction appears to be directly related to the level of C-reactive protein, raising the possibility that antiinflammatory agents may have clinical benefits in preventing cardiovascular disease.
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pubMassachusetts Medical Society
urlhttp://search.proquest.com/docview/223981160/
doi10.1056/NEJM199704033361401
eissn15334406
date1997-04-03