The association between C-reactive protein and coronary artery calcification: a systematic review and meta-analysis

BMC Cardiovasc Disord. 2024 Apr 10;24(1):204. doi: 10.1186/s12872-024-03856-5.

Abstract

Background: While coronary artery calcification (CAC) is recognized as a reliable marker for coronary atherosclerosis, the relationship between the concentration of C-reactive protein (CRP) and the incidence and progression of CAC remains controversial.

Method: PubMed, Embase, Web of Science, and Scopus were systematically searched to identify relevant observational studies until October 2023. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was employed to calculate pooled odd ratios (OR) and corresponding 95% confidence intervals, considering heterogeneity among the studies.

Results: Out of the 2545 records, 42 cross-sectional and 9 cohort studies were included in the systematic review. The meta-analysis on 12 eligible cross-sectional studies revealed no significant association between CAC and CRP [pooled OR: 1.03 (1.00, 1.06)]. Additionally, an insignificant association was found between CAC and CRP through meta-analysis on three eligible cohort studies [pooled OR: 1.05 (0.95, 1.15)] with no considerable heterogeneity across studies. Sensitivity analyses indicated that the meta-analysis models were robust. There was no evidence of publication bias.

Conclusion: Based on the meta-analysis findings, elevated levels of CRP did not emerge as a valuable prognostic maker for CAC incidence and progression prediction.

Keywords: CAC; CRP; Calcium score; High sensitivity C-reactive protein; Meta-analysis; hs-CRP.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • C-Reactive Protein* / analysis
  • Coronary Artery Disease* / diagnosis
  • Cross-Sectional Studies
  • Humans
  • Risk Factors
  • Vascular Calcification* / diagnosis

Substances

  • C-Reactive Protein