Evaluation of the association between the first observation and the longitudinal change in C-reactive protein, and all-cause mortality

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Abstract
Objective: To evaluate the association between vascular inflammation as measured by subacute C-reactive protein (CRP; 1–10 mg/l) and all-cause mortality and the association between change in CRP status (normal ⩽3 mg/l and elevated >3 mg/l) and all-cause mortality. Methods: Probabilistic record linkage was used to match hospital episode data, laboratory reports and mortality statistics in a large urban population. Survival was evaluated using Cox proportional hazards regression models. Results: 22 962 patients had their first CRP measurement in the subacute range (1–10 mg/l). Analysis grouped by each additional unit increase in CRP across the subacute range was associated with a 7.3% (95% CI 5.4% to 9.2%) increase in the hazard ratio (HR) of death over 4 years, after controlling for confounding factors (p3 mg/l), the HR increased 6.7-fold (pConclusions: CRP level predicted all-cause mortality, and additional inclusion of prior change in CRP level and current CRP level more so. Increasing vascular inflammation, as measured by CRP, increases the likelihood of death.

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