{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T15:11:26Z","timestamp":1770995486213,"version":"3.50.1"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,6,5]]},"abstract":"\n Background<\/jats:title>\n \n The joint effect of atherosclerosis and CRP (C\u2010reactive protein) on risk of ischemic stroke (\n IS<\/jats:styled-content>\n ) and myocardial infarction (\n MI<\/jats:styled-content>\n ) has been sparsely studied. The aim of this study was to explore whether\n CRP<\/jats:styled-content>\n mediates the risk of events in subjects with prevalent carotid plaque, examine synergism, and test whether\n CRP<\/jats:styled-content>\n and carotid plaque add to risk prediction beyond traditional risk factors.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n CRP<\/jats:styled-content>\n and carotid total plaque area (\n TPA<\/jats:styled-content>\n ) were measured in 10 109 participants in the Troms\u00f8 Study from 1994 to 2008. Incident\n IS<\/jats:styled-content>\n (n=671) and\n MI<\/jats:styled-content>\n (n=1079) were registered until December 31, 2013. We calculated hazard ratios (HRs) of\n MI<\/jats:styled-content>\n and\n IS<\/jats:styled-content>\n according to categories of\n CRP<\/jats:styled-content>\n (<1, 1\u20133, and >3\u00a0mg\/L) and plaque status (no plaque and\n TPA<\/jats:styled-content>\n below and above median) in Cox proportional hazard models with time\u2010varying covariates. Multivariable\u2010adjusted\n CRP<\/jats:styled-content>\n >3 versus <1\u00a0mg\/L was associated with risk of\n IS<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n , 1.84; 95% confidence interval, 1.49\u20132.26) and\n MI<\/jats:styled-content>\n (\n HR,<\/jats:styled-content>\n 1.46; 95% confidence interval, 1.23\u20131.73).\n TPA<\/jats:styled-content>\n above median versus no plaque was associated with risk for\n IS<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n , 1.65; 95% confidence interval, 1.36\u20132.01) and\n MI<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n , 1.64; 95% confidence interval, 1.41\u20131.92). In participants with plaque, adjustment for\n CRP<\/jats:styled-content>\n minimally attenuated the risk estimates. The highest incidence rates for\n MI<\/jats:styled-content>\n and\n IS<\/jats:styled-content>\n were seen in the group with both\n CRP<\/jats:styled-content>\n >3\u00a0mg\/L and TPA is above the median.\n TPA<\/jats:styled-content>\n and\n CRP<\/jats:styled-content>\n combined added to risk prediction beyond traditional risk factors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The simultaneous presence of subclinical atherosclerosis and elevated\n CRP<\/jats:styled-content>\n was associated with increased risk of\n IS<\/jats:styled-content>\n and\n MI<\/jats:styled-content>\n . The combined assessment of subclinical atherosclerosis and inflammatory biomarkers may improve cardiovascular disease risk stratification.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.008951","type":"journal-article","created":{"date-parts":[[2018,5,17]],"date-time":"2018-05-17T09:15:20Z","timestamp":1526548520000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Joint Effect of Carotid Plaque and C\u2010Reactive Protein on First\u2010Ever Ischemic Stroke and Myocardial Infarction?"],"prefix":"10.1161","volume":"7","author":[{"given":"Agnethe","family":"Eltoft","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Department of Neurology, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjell Arne","family":"Arntzen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Department of Neurology, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Wilsgaard","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John\u2010Bjarne","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, K.G. Jebsen Thrombosis Research and Expertise Center, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Division of Internal Medicine, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellisiv B.","family":"Mathiesen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Department of Neurology, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stein Harald","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Department of Neurology, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000087481.55887.C9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.11.014"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61717-7"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyn217"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.115.306656"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707402"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2017.07.001"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.04.007"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.10.040"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq238"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.10.070"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.645606"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.08.028"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr049"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1403494812469851"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.11.2201"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2005.09.006"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.646596"},{"key":"e_1_3_4_20_2","unstructured":"MORGAM project . 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