Can measuring markers of inflammation improve the prediction of cardiovascular event risk?
hs-CRP Inflammation Test, a case-control study (N Engl J Med 2000, PMID 10733371) — in multivariate analyses, only hs-CRP (relative risk 1.5) and the ratio of total cholesterol to HDL cholesterol (relative risk 1.4) independently predicted risk. Adding C-reactive protein to standard lipid screening can better identify postmenopausal women at risk for cardiovascular events.
Source: N Engl J Med 2000, PMID 10733371 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
N Engl J Med · 2000 · PMID 10733371 · DOI 10.1056/NEJM200003233421202
Adding C-reactive protein to standard lipid screening can better identify postmenopausal women at risk for cardiovascular events.
The question
Can measuring markers of inflammation improve the prediction of cardiovascular event risk?
What they tested
Measurement of markers of inflammation, in addition to traditional risk factors, will improve the prediction of cardiovascular event risk.
How they did it
A prospective, nested case-control study was conducted among 28,263 apparently healthy postmenopausal women over a mean follow-up of three years. Researchers assessed the risk of cardiovascular events associated with baseline levels of various markers, including high-sensitivity C-reactive protein (hs-CRP), serum amyloid A, interleukin-6, soluble intercellular adhesion molecule type 1 (sICAM-1), homocysteine, and lipid measurements. Cardiovascular events included death from coronary heart disease, nonfatal myocardial infarction or stroke, or the need for coronary-revascularization procedures.
What they found
Hs-CRP was the strongest univariate predictor of cardiovascular events, with a relative risk of 4.4 for women in the highest versus lowest quartile. Other significant univariate predictors included serum amyloid A (3.0), sICAM-1 (2.6), interleukin-6 (2.2), homocysteine (2.0), total cholesterol (2.4), LDL cholesterol (2.4), apolipoprotein B-100 (3.4), HDL cholesterol (0.3), and the ratio of total cholesterol to HDL cholesterol (3.4). Prediction models incorporating inflammation markers and lipids were significantly better than lipid-only models (P<0.001). Hs-CRP and serum amyloid A were significant predictors even in women with LDL cholesterol below 130 mg/dL. In multivariate analyses, only hs-CRP (relative risk 1.5) and the ratio of total cholesterol to HDL cholesterol (relative risk 1.4) independently predicted risk.
| hs-CRP | 4.4 | |
|---|---|---|
| Serum Amyloid A | 3 | |
| sICAM-1 | 2.6 | |
| Interleukin-6 | 2.2 | |
| Homocysteine | 2 | |
| Total Cholesterol | 2.4 | |
| LDL Cholesterol | 2.4 | |
| Apolipoprotein B-100 | 3.4 | |
| HDL Cholesterol | 0.3 | |
| Total Chol/HDL Chol Ratio | 3.4 |
This chart shows the univariate relative risk of cardiovascular events for women in the highest quartile compared to the lowest quartile for various markers.
What it means
Adding C-reactive protein measurement to lipid-based screening may improve the identification of individuals at risk for cardiovascular events.
Limitations
The study was conducted in apparently healthy postmenopausal women, which may limit generalizability to other populations. The follow-up period was a mean of three years, which might not capture long-term risks.
The paper at a glance
| Title | C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women |
|---|---|
| Journal | N Engl J Med |
| Year | 2000 |
| PMID | 10733371 ↗ |
| DOI | 10.1056/NEJM200003233421202 ↗ |
| Topic | Cardiovascular & vascular aging |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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hs-CRP Inflammation Test
Across large prospective cohorts and meta-analyses, higher hs-CRP is consistently associated with increased risk of coronary heart disease, stroke, cardiovascular and non-vascular mortality, and with aging-related states such as frailty and dementia;
High-sensitivity C-reactive protein (hs-CRP) is a blood test that measures very low concentrations of…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). Can measuring markers of inflammation improve the prediction of cardiovascular event risk? [Plain-English summary of N Engl J Med 2000, PMID 10733371, DOI 10.1056/NEJM200003233421202]. Magellan Longevity. https://magellanlongevity.com/study/d10733371.html@misc{magellan_d10733371,
title = {Can measuring markers of inflammation improve the prediction of cardiovascular event risk?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/d10733371.html}},
note = {Plain-English summary of PubMed PMID 10733371; DOI 10.1056/NEJM200003233421202; N Engl J Med 2000. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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