Aims: C-reactive protein (CRP), the classic acute-phase protein, plays an important role in the etiology of myocardial infarction (MI). Emerging evidence has shown that the common polymorphisms in the CRP gene may influence an individual's susceptibility to MI; but individually published studies showed inconclusive results. This meta-analysis aimed to derive a more precise estimation of the associations between CRP gene polymorphisms and MI risk. Methods: A literature search of PubMed, Embase, Web of Science, and China BioMedicine (CBM) databases was conducted on articles published before June 1st, 2013. Crude odds ratio (OR) with 95% confidence interval (CI) were calculated. Results: Nine case-control studies were included with a total of 2992 MI patients and 4711 healthy controls. The meta-analysis results indicated that CRP rs3093059 (T>C) polymorphism was associated with decreased risk of MI, especially among Asian populations. However, similar associations were not observed in CRP rs1800947 (G>C) and rs2794521 (G>A) polymorphisms (all p>0.05) among both Asian and Caucasian populations. Univariate and multivariate meta-regression analyses showed that ethnicity may be a major source of heterogeneity. No publication bias was detected in this meta-analysis. Conclusion: In conclusion, the current meta-analysis indicates that CRP rs3093059 (T>C) polymorphism may be associated with decreased risk of MI, especially among Asian populations.
Get full access to this article
View all access options for this article.
References
1.
Akbarzadeh NajarR, GhaderianSM, Tabatabaei PanahAS. 2012. C-reactive protein (CRP) gene polymorphisms: implication in CRP plasma levels and susceptibility to acute myocardial infarction. Mol Biol Rep, 39:3705-3712.
2.
BalistreriCR, VastoS, ListiFet al.2006. Association between +1059G/C CRP polymorphism and acute myocardial infarction in a cohort of patients from Sicily: a pilot study. Ann N Y Acad Sci, 1067:276-281.
3.
BisJC, HeckbertSR, SmithNLet al.2008. Variation in inflammation-related genes and risk of incident nonfatal myocardial infarction or ischemic stroke. Atherosclerosis, 198:166-173.
4.
BrullDJ, SerranoN, ZitoFet al.2003. Human CRP gene polymorphism influences CRP levels: implications for the prediction and pathogenesis of coronary heart disease. Arterioscler Thromb Vasc Biol, 23:2063-2069.
5.
BujakM, FrangogiannisNG. 2007. The role of TGF-beta signaling in myocardial infarction and cardiac remodeling. Cardiovasc Res, 74:184-195.
6.
da CostaBR, CevallosM, AltmanDGet al.2011. Uses and misuses of the STROBE statement: bibliographic study. BMJ Open, 1:e000048.
7.
DaiDF, ChiangFT, LinJLet al.2007. Human C-reactive protein (CRP) gene 1059G>C polymorphism is associated with plasma CRP concentration in patients receiving coronary angiography. J Formos Med Assoc, 106:347-354.
FrangogiannisNG. 2012. Monomeric C-reactive protein and inflammatory injury in myocardial infarction. Cardiovasc Res, 96:4-6.
10.
FranklinBA. 2012. ACP Journal Club. Multifactorial cardiac rehabilitation did not reduce mortality or morbidity after acute myocardial infarction. Ann Intern Med, 157:JC2-JC11.
11.
GhattasMH, Abo-ElmattyDM, El-ErakiAZ. 2012. C-reactive protein 1059G/C gene polymorphism, C-reactive protein levels and acute myocardial infarction. J Cardiovasc Med (Hagerstown), 13:716-719.
12.
HeGP, YangHT, QiCPet al.2012. Relationship between serum CRP level and gen T-757C polymorphism in patients with acute myocardial infarction. J Clin Cardiol, 28:413-415.
13.
JacksonD, WhiteIR, RileyRD. 2012. Quantifying the impact of between-study heterogeneity in multivariate meta-analyses. Stat Med, 31:3805-3820.
14.
JanketSJ, BairdAE, ChuangSKet al.2003. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 95:559-569.
15.
JeongHC, AhnY, HongYJet al.2012. Statin therapy to reduce stent thrombosis in acute myocardial infarction patients with elevated high-sensitivity C-reactive protein. Int J Cardiol, 167:1848-1853.
16.
KeechA, SimesRJ, BarterPet al.2005. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet, 366:1849-1861.
17.
LangeLA, CarlsonCS, HindorffLAet al.2006. Association of polymorphisms in the CRP gene with circulating C-reactive protein levels and cardiovascular events. JAMA, 296:2703-2711.
18.
LeeCC, YouNC, SongYet al.2009. Relation of genetic variation in the gene coding for C-reactive protein with its plasma protein concentrations: findings from the Women's Health Initiative Observational Cohort. Clin Chem, 55:351-360.
19.
MartinsOM, FonsecaVF, BorgesIet al.2011. C-Reactive protein predicts acute myocardial infarction during high-risk noncardiac and vascular surgery. Clinics (Sao Paulo), 66:773-776.
20.
MontecuccoF, BauerI, BraunersreutherVet al.2013. Inhibition of nicotinamide phosphoribosyltransferase reduces neutrophil-mediated injury in myocardial infarction. Antioxid Redox Signal, 18:630-641.
21.
NabelEG, BraunwaldE. 2012. A tale of coronary artery disease and myocardial infarction. N Engl J Med, 366:54-63.
22.
OchrietorJD, HarrisonKA, ZahediKet al.2000. Role of STAT3 and C/EBP in cytokine-dependent expression of the mouse serum amyloid P-component (SAP) and C-reactive protein (CRP) genes. Cytokine, 12:888-899.
23.
PetersJL, SuttonAJ, JonesDRet al.2006. Comparison of two methods to detect publication bias in meta-analysis. JAMA, 295:676-680.
24.
PetrieCJ, VoorsAA, RobertsonMet al.2012. A low pulse pressure predicts mortality in subjects with heart failure after an acute myocardial infarction: a post-hoc analysis of the CAPRICORN study. Clin Res Cardiol, 101:29-35.
25.
RamanK, ChongM, Akhtar-DaneshGGet al.2013. Genetic markers of inflammation and their role in cardiovascular disease. Can J Cardiol, 29:67-74.
26.
ReinerAP, BelezaS, FranceschiniNet al.2012. Genome-wide association and population genetic analysis of C-reactive protein in African American and Hispanic American women. Am J Hum Genet, 91:502-512.
27.
RidkerPM, HennekensCH, BuringJEet al.2000. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med, 342:836-843.
28.
SchoosMM, Munthe-FogL, SkjoedtMOet al.2013. Association between lectin complement pathway initiators, C-reactive protein and left ventricular remodeling in myocardial infarction-A magnetic resonance study. Mol Immunol, 54:408-414.
29.
ShaliaK, SavantS, HaldankarVAet al.2012. Study of C-reactive protein and myocardial infarction in the Indian population. Indian J Clin Biochem, 27:74-82.
30.
ShiffmanD, O'MearaES, RowlandCMet al.2011. The contribution of a 9p21.3 variant, a KIF6 variant, and C-reactive protein to predicting risk of myocardial infarction in a prospective study. BMC Cardiovasc Disord, 11:10.
31.
SinghMV, SwaminathanPD, LuczakEDet al.2012. MyD88 mediated inflammatory signaling leads to CaMKII oxidation, cardiac hypertrophy and death after myocardial infarction. J Mol Cell Cardiol, 52:1135-1144.
32.
SjowallC, CardellK, BostromEAet al.2012. High prevalence of autoantibodies to C-reactive protein in patients with chronic hepatitis C infection: association with liver fibrosis and portal inflammation. Hum Immunol, 73:382-388.
33.
van MelleJP, de JongeP, SpijkermanTAet al.2004. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med, 66:814-822.
34.
VatayA, BeneL, KovacsAet al.2003. Relationship between the tumor necrosis factor alpha polymorphism and the serum C-reactive protein levels in inflammatory bowel disease. Immunogenetics, 55:247-252.
35.
VermaS, WangCH, LiSHet al.2002. A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation, 106:913-919.
36.
VolanakisJE. 2001. Human C-reactive protein: expression, structure, and function. Mol Immunol, 38:189-197.
37.
WangB, HeH, QuHXet al.2010. C-Reaction Protein Gene T-757C Polymorphism in the promoter region in patients with acute myocardial infarction. Molecular Cardiology of China, 10:297-300.
38.
WennbergP, WensleyF, Di AngelantonioEet al.2012. Haemostatic and inflammatory markers are independently associated with myocardial infarction in men and women. Thromb Res, 129:68-73.
39.
WensleyF, GaoP, BurgessSet al.2011. Association between C reactive protein and coronary heart disease: mendelian randomisation analysis based on individual participant data. BMJ, 342:d548.
40.
ZebrackJS, AndersonJL, MaycockCAet al.2002. Usefulness of high-sensitivity C-reactive protein in predicting long-term risk of death or acute myocardial infarction in patients with unstable or stable angina pectoris or acute myocardial infarction. Am J Cardiol, 89:145-149.
41.
ZeeRY, RidkerPM. 2002. Polymorphism in the human C-reactive protein (CRP) gene, plasma concentrations of CRP, and the risk of future arterial thrombosis. Atherosclerosis, 162:217-219.
42.
ZhaoBC, DaiXH, YangRXet al.2006. Influence of the C-reactive Protein Level and Gene Polymorphism on the Prognosis of the Acute Myocardial Infartion. Chin Gen Pract, 09:807-808.
