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C-reactive protein as a marker of cardiovascular disease in patients with a schizophrenia spectrum disorder treated in routine medical practice

Published online by Cambridge University Press:  02 October 2011

A. Sicras-Mainar ,
J. Rejas-Gutiérrez ,
R. Navarro-Artieda  and
M. Blanca-Tamayo
A. Sicras-Mainar*
Affiliation:
Directorate of Planning, Badalona Serveis Assistencials, Badalona (Barcelona), Spain
J. Rejas-Gutiérrez
Affiliation:
Department of Health Outcomes Research, Corporate Affairs and Market Access Unit, Pfizer España, Alcobendas (Madrid), Spain
R. Navarro-Artieda
Affiliation:
Department of Medical Documentation, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
M. Blanca-Tamayo
Affiliation:
Department of Psychiatry, Badalona Serveis Assistencials, Badalona (Barcelona), Spain
*
⁎Corresponding author. Tel.: +34 93 5072684. E-mail address:[email protected] (A. Sicras-Mainar).
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Abstract

Objective

Interest in cardiovascular diseases (CVD) in schizophrenia has grown recently due to documented incremental mortality. C-reactive protein (CRP) has been assessed as a marker in individuals with CVD and/or at high risk of developing it. However, its role in schizophrenia patients is unknown. The goal of this research was thus to explore the use of CRP as a marker of CVD risk in patients with schizophrenia.

Methods

A cross-sectional analysis of the Badalona Serveis Assistencials (BSA) administrative claims database was conducted including all subjects aged > 18 years with a diagnosis of schizophrenia spectrum disorder. CRP measurement, sociodemographics, medical history, 10-year CVD risk (Framingham function) and clinical chemistry data were extracted for analysis.

Results

Seven hundred and five patients (53.0% men, 48.2 [15.8] years, 78.7% on atypicals) met criteria for analysis. Mean 10-year CVD risk was high; 11.9 ± 5.7% and mean CRP levels were 2.6 ± 2.5 mg/L with 30.4% showing above-normative levels (> 3 mg/L). After adjusting for age, gender, smoking and presence of neoplasm or inflammatory diseases, CRP was linearly associated with 10-year CVD risk stratified by risk (low, moderate, high/very high): respectively, 2.3 (95% CI: 2.1–2.5), 3.1 (2.6–3.5) and 3.7 (3.2–4.1) mg/L; F = 13.5, P < 0.001. Patients with known CVD also showed higher CRP levels: 3.7 (2.9–4.5) vs. 2.5 (2.4–2.7) mg/L, P = 0.008; and higher probability of above-normal values; odds ratio = 4.71 (2.01–11.04), P < 0.001.

Conclusions

High CRP levels above normative were associated with both known CVD and high/very high 10-year risk of a CVD event in patients with schizophrenia, suggesting CRP could be a marker of CVD in this psychiatric disorder.

Keywords

C-reactive proteinSchizophrenia spectrum disordersCardiovascular riskFramingham functionReal world
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 3 , March 2013 , pp. 161 - 167
Copyright
Copyright © European Psychiatric Association 2011

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