We sought to test the hypothesis that C-reactive protein, a marker of inflammation,
would correlate positively with coronary calcium, a marker of atherosclerosis, in
postmenopausal women.
High sensitivity testing for C-reactive protein (hsCRP) has recently been shown in
large population studies to predict cardiac events in asymptomatic postmenopausal
women. Coronary calcification determined by electron beam computerized tomography
(EBCT) has also been suggested to be predictive of cardiac events in women.
We performed hsCRP testing and determined calcium scores by EBCT in 172 asymptomatic
postmenopausal women (mean age: 64.5 +/- 7.9 years) at risk for cardiac disease. Risk
factors were determined by history, physical, electrocardiogram, exercise testing,
and lipoprotein profiles.
Calcium scores ranged from 0 to 2,618. For analysis, calcium scores were divided into
three groups; none (0 to 10), minimal (>10 to 50), and significant (>50). Overall,
there was no significant positive relationship between hsCRP level and calcium score.
Specifically, the hsCRP levels (mg/dl) were 0.24 +/- 0.43, 0.33 +/- 0.47 and 0.17
+/- 0.32 (medians 0.11, 0.15, and 0.06) for women with none, minimal, and significant
coronary calcification, respectively. In subgroup analysis, a similar lack of positive
association was observed after stratification by smoking status and by hormone replacement
therapy use, two factors known to increase hsCRP.
In contrast to our a priori hypothesis, we found no evidence of a positive association
between hsCRP and calcium score by EBCT. These data thus raise the possibility that
hsCRP and EBCT calcium score reflect different pathologic processes, an issue with
implications for coronary artery disease screening.