Determinants of the acute phase protein CRP in myocardial infarction survivors

Background: C-reactive protein (CRP), a sensitive marker of the
acute phase response, has been associated with future
cardiovascular endpoints independent of other risk factors such as
body mass index (BMI), age and cholesterol levels. Risk assessment
in populations at risk of cardiovascular disease is usually based
on one or two measurements. Variation of CRP among certain
subgroups of the population, however, has not been examined in
detail. The purpose of this thesis is to study associations between
time-invariant patient characteristics and mean high sensitivity
(hs)-CRP concentrations and parameters that influence the variation
of hs-CRP in a joint analysis. Additionally, associations between
parameters that might impact hs-CRP in the 24 hours before the
blood draw, such as environmental tobacco smoke exposure, alcohol
consumption or extreme stress or anger, were examined. Moreover,
the short-term impact of ambient air pollution on hs-CRP was
studied. Methods: This thesis is based on AIRGENE, a multi centre
study conducted in six European cities. Hs-CRP was measured
repeatedly up to eight times every four to six weeks in 1,003
myocardial infarction (MI) survivors. At the first visit data on
health status, medication intake and smoking history were collected
by questionnaire. Blood pressure and BMI were measured and a blood
serum sample was drawn. An additional blood sample was drawn at
each visit for the determination of hs-CRP and data on life-style
in the 24 hours before the visit were collected. In each city,
hourly data on particle number concentrations, mass concentrations
of particulate matter (PM)