High-sensitivity C-reactive protein and all-cause mortality in four diverse populations: The CRONICAS Cohort Study

Purpose: To assess the association between all-cause mortality and hs-CRP, based mainly on the cumulative burden approach. Methods: Cohort study with adults >= 35 years from general population, using hs-CRP at two timepoints: at baseline and 30 months later to establish different exposures: change over time, cumulative, and weighted cumulative hs-CRP. The outcome was all-cause mortality assessed 7 years later. Cox models were generated to quantify the association. Results: Data from 3,119 participants (mean age 55.6 years, and 51.2% females), were analyzed. During follow-up, 164 (5.6%) deaths occurred over 20,314.5 person-years, indicating an overall mortality rate of 8.1 per 1,00 0 person-years. In multivariable model, hs-CRP at baseline was associated with high risk of mortality (HR = 1.77; 95%CI: 1.28-2.46). Similarly, hs-CRP change over time (HR = 2.50; 95%CI: 1.46-4.29), as well as cumulative and weighted cumulative hs-CRP (HR = 2.05; 95%CI: 1.31-3.20) were associated with greater risk of all-cause mortality. The weighted cumulative hs-CRP had the best goodness-of-fit for mortality prediction. Conclusions: In this cohort across diverse geographical low-resource settings, high levels of hs-CRP were strongly associated with all-cause mortality. Two measurements of hs-CRP are better than one to predict mortality, and the weighted cumulative approach had the best prognostic fit. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study assessed the association between hs-CRP and all-cause mortality using the cumulative burden approach. The results showed that high levels of hs-CRP were strongly associated with all-cause mortality. Additionally, two measurements of hs-CRP were better than one in predicting mortality, and the weighted cumulative approach had the best prognostic fit.