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Association between C-reactive protein with all-cause mortality in ELSA-Brasil cohort

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Maluf, Chams B., Barreto, Sandhi M., Giatti Gonçalves, Luana, Ribeiro, Luiz P., Vidigal, Pedro G., Azevedo, Douglas R. M., Griep, Rosane H., Alvim Matos, Sheila M., Ji, Chen, Cappuccio, Francesco P. and Miller, Michelle A. (2020) Association between C-reactive protein with all-cause mortality in ELSA-Brasil cohort. Journal of Epidemiology and Community Health, 74 (5). pp. 421-427. doi:10.1136/jech-2019-213289

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Official URL: http://www.doi.org/10.1136/jech-2019-213289

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Abstract

Background: High-sensitive C-reactive protein (hsCRP) has been proposed as a marker of incident cardiovascular disease and vascular mortality, and it may also be a marker of non-vascular mortality. However, most evidence comes from either North American or European cohorts. The present proposal aims to investigate the association of high-sensitive C-reactive protein with the risk of all-cause mortality in a multi-ethnic Brazilian population
Methods: Cohort data from baseline (2008–2010) of 14 792 subjects participating in the Brazilian Longitudinal Study of Adult Health were used. HsCRP was assayed with Immunochemistry. The association of baseline covariates with all-cause mortality was calculated by Cox regression for univariate model and adjusted for different confounders after mean follow-up of 8.0 ± 1.1 years. The final model was adjusted for age, sex, self-rated race/ethnicity, schooling, health behaviours and prevalent chronic disease.
Results: The risk of death increased steadily by quartiles of hsCRP from 1.45 (95% Confidence Interval: 1.05, 2.01) in Quartile 2 to 1.95 (1.42, 2.69) in Quartile 4 compared to Quartile 1. Furthermore, the persistence of a significant graded association after the exclusion of deaths in the first year of follow-up suggests that these results are unlikely to be due to reverse causality. Finally, the hazard ratios were unaffected by the exclusion of participants that had self-reported past medical history for diabetes, cancer and chronic obstructive pulmonary disease.
Conclusions: Our study shows that hsCRP levels is associated with mortality in a highly admixed population, independently of a large set of lifestyle and clinical variables.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Journal of Epidemiology and Community Health
Publisher: B M J Group
ISSN: 0143-005X
Official Date: 15 April 2020
Dates:
DateEvent
15 April 2020Published
26 February 2020Available
22 January 2020Accepted
Date of first compliant deposit: 24 January 2020
Volume: 74
Number: 5
Page Range: pp. 421-427
DOI: 10.1136/jech-2019-213289
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Copyright Holders: BMJ
Funder: UUKi Rutherford Fund, Brazilian Ministry of Health, Brazilian Ministry of Science and Technology, Brazilian National Research Council
Grant number: 01060010.00RS; 01060212.00BA; 01060300.00ES; 01060278.00MG; 010601115.00SP; 01060071.00RJ
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