In this prospective study of 5,360 men (mean age = 77 years) followed for an average period of 7 years, the predictive value of inflammatory markers such as C-reactive protein (CRP), fibrinogen, and albumin was compared to the predictive value of the cholesterol/HDL cholesterol ratio. The hazard ratio of future ischemic heart disease (IHD) mortality per 2-standard deviation increase in CRP was 2.52 (95% CI, 2.0-3.17), 1.79 (95% CI, 1.42-2.26) for fibrinogen, 0.57 (95% CI, 0.43-0.74) for albumin, and 1.52 (95% CI, 1.28-1.80) for the cholesterol/HDL cholesterol ratio. After adjusting for potential lipid and inflammatory confounders, only fibrinogen lost its predictive ability. These results led the authors to conclude that CRP and albumin might increase IHD risk by reflecting underlying inflammatory disease or because of their associations with other potential risk factors (inflammatory or not). These findings also suggest that in aging asymptomatic men, measuring inflammatory markers might provide further information on IHD risk and optimize therapeutic management.
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