Despite extensive epidemiological data on C-reactive protein (CRP), few studies have examined the relationship between longitudinal changes in CRP and prognosis. The authors of this study quantified the association between vascular inflammation, as measured by subacute CRP (1-10 mg/l), and all-cause mortality as well as the association between changes in CRP status and all-cause mortality. Results showed that each unit increase in CRP within the subacute range resulted in a 7.3% (95% CI, 5.4%-9.2%) increase in the hazard ratio of death over 4 years, after controlling for age, gender, prior cancer, prior diabetes, and pre-existing vascular disease. Furthermore, the likelihood of death over 3 years was markedly greater in subjects whose serum CRP had increased from normal to elevated levels than subjects whose CRP decreased over a 1 year observation period. These findings illustrate the striking association between CRP changes observed over 1 year and subsequent 4 year all-cause mortality. Among subjects in whom CRP diminished from elevated to normal status, the risk of death dropped by 50% compared to subjects whose CRP became or remained elevated over the observation period.
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