Basal high-sensitivity-C-reactive protein levels in patients with spontaneous venous thromboembolism

Rainer Vormittag; Thomas Vukovich; Verena Schönauer; Stephan Lehr; Erich Minar; Christine Bialonczyk; Mirko Hirschl; Ingrid Pabinger

doi:10.1160/TH04-11-0745

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(03): 488-493
DOI: 10.1160/TH04-11-0745

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Basal high-sensitivity-C-reactive protein levels in patients with spontaneous venous thromboembolism

Rainer Vormittag

¹Department of Internal Medicine I, Division of Haematology and Haemostaseology, University Hospital Vienna, Vienna, Austria

,

Thomas Vukovich

²Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Vienna, Vienna, Austria

,

Verena Schönauer

¹Department of Internal Medicine I, Division of Haematology and Haemostaseology, University Hospital Vienna, Vienna, Austria

,

Stephan Lehr

³Department of Medical Computer Sciences, Section of Clinical Biometrics, University Hospital Vienna, Vienna, Austria

,

Erich Minar

⁴Department of Internal Medicine II, Division of Angiology, University Hospital Vienna, Vienna, Austria

,

Christine Bialonczyk

⁵Department of Dermatology, Wilhelminenspital Vienna, Vienna, Austria

,

Mirko Hirschl

⁶Department of Angiology, Hanusch-Krankenhaus Vienna, Vienna, Austria

,

Ingrid Pabinger

› Author Affiliations

Abstract

Summary

The role of C-reactive protein (CRP) in venous thromboembolism (VTE) is still under discussion because of controversial results in the literature. Conflicting data may have partly been due to bias by exogenous factors altering CRP levels. We investigated CRP concentrations in patients with spontaneous VTE applying a study design that allowed the measurement of basal high sensitivity (hs)-CRP levels. Patients with a history of deep vein thrombosis (DVT, n=117) and pulmonary embolism (PE, n=97) were compared to healthy individuals (n=104). Hs-CRP levels (mg/dl) were significantly higher in patients (n=214, median/interquartile range: 0.171/0.082–0.366) than in controls (0.099/0.053–0.245, p=0.001). The unadjusted odds ratio (OR) for VTE per 1 mg/dl increase of CRP was 2.8 [95% confidence interval (CI): 1.1–6.8, p=0.03]. This association remained significant after adjustment for factor V Leiden, prothrombin G20210A and factor VIII activity above 230% (OR = 2.9, 95% CI [1.1–7.5]), but became remarkably attenuated and lost its statistical significance after adjustment for BMI alone (OR = 1.7 [0.7–4.0]). CRP was also not independently associated with VTE in subgroups of patients (those with DVT without symptomatic PE, those with PE and patients without established risk factor) in multiple regression analysis. In summary, we observed significantly higher basal hs-CRP levels in patients with spontaneous VTE compared to healthy controls. This association was independent of hereditary and laboratory risk factors for VTE, but lost its significance after adjustment for BMI. Increased basal CRP levels do not appear to represent an independent risk factor for VTE.

Keywords

Venous thrombosis - pulmonary embolism - C-reactive protein - body mass index

Full Text

References

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