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document
Prospective study of C-reactive protein , homocysteine , and plasma lipid levels as predictors of sudden cardiac death . BACKGROUND Sudden cardiac death ( SCD ) is an important cause of mortality even among apparently healthy populations . However , our ability to identify those at risk for SCD in the general population is poor , and more specific markers are needed . METHODS AND RESULTS To compare and contrast the relative importance of C-reactive protein ( CRP ) , homocysteine , and lipids as long-term predictors of SCD , we performed a prospective , nested , case-control analysis involving 97 cases of SCD among apparently healthy men enrolled in the Physician 's Health Study . Of these plasma markers measured , only baseline CRP levels were significantly associated with the risk of SCD over the ensuing 17 years of follow-up ( P for trend=0.001 ) . The increase in risk associated with CRP levels was primarily seen among men in the highest quartile , who were at a 2.78-fold increased risk of SCD ( 95 % CI 1.35 to 5.72 ) compared with men in the lowest quartile . These results were not significantly altered in analyses that ( in addition to the matching variables of age and smoking status ) controlled for lipid parameters , homocysteine , and multiple cardiac risk factors ( relative risk for highest versus lowest quartile 2.65 , 95 % CI 0.79 to 8.83 ; P for trend=0.03 ) . In contrast to the positive relationship observed for CRP , neither homocysteine nor lipid levels were significantly associated with risk of SCD . CONCLUSIONS These prospective data suggest that CRP levels may be useful in identifying apparently healthy men who are at an increased long-term risk of SCD .
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Intervention_Pharmacological
C-reactive protein ( CRP )
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Intervention_Pharmacological
homocysteine
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Intervention_Pharmacological
lipids
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Intervention_Pharmacological
CRP
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Intervention_Pharmacological
CRP
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Outcome_Physical
C-reactive protein , homocysteine , and plasma lipid levels
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Outcome_Physical
Sudden cardiac death ( SCD )
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Outcome_Physical
C-reactive protein ( CRP ) , homocysteine , and lipids
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Outcome_Physical
CRP levels
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Outcome_Physical
CRP levels
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Outcome_Physical
SCD
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Outcome_Physical
lipid parameters , homocysteine , and multiple cardiac risk factors
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Outcome_Physical
SCD
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Outcome_Physical
long-term risk of SCD .
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Participant_Sample-size
97
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Participant_Condition
SCD
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Participant_Condition
apparently healthy
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Participant_Sex
men
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Participant_Condition
at an increased long-term risk of SCD