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Blood proteins tied to inflammation

A Johns Hopkins-led study shows that two proteins, C-reactive protein and albumin, are accurate predictors of heart attack or stroke in kidney dialysis patients. The research team found that high levels of C-reactive protein, a marker of inflammation, and low levels of albumin, a sign of malnutrition, had strong ties to heart disease in these patients, who are many times more likely to develop heart problems than the general population.

"Both inflammation and malnutrition play an important role in the high risk of cardiovascular disease among dialysis patients," says Josef Coresh, M.D., Ph.D., lead author of the study and associate professor of epidemiology, medicine and biostatistics at Hopkins. "Testing for these proteins will allow us to sooner identify patients at high risk, and to manage heart disease risk factors more effectively."

Results of the study are to be presented Nov. 18 at the American Heart Association's 75th annual Scientific Sessions in Chicago.

Coresh and colleagues examined data from the Choices for Healthy Outcomes in Caring for End-stage renal disease (CHOICE) Study, a Hopkins effort that followed more than 1,000 dialysis patients nationwide between October 1995 and June 1998. For this study, they collected blood samples from 810 patients who had been on dialysis for an average of four months and measured levels of C-reactive protein and albumin. They also reviewed the patients' medical records until November 2000.

During the follow-up period, the patients had a combined 278 heart events, including heart attack, bypass surgery, angioplasty, stroke, carotid endarterectomy (a procedure to remove plaque from the neck artery), peripheral vascularization (a type of angioplasty used to dilate narrowed arteries in the legs), or amputation. The risk of heart disease increased with high C-reactive protein levels and low albumin levels, even after adjusting for factors like cholesterol level, smoking status an
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Contact: Karen Blum
kblum@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
18-Nov-2002


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