5341 - Plasma Concentration of TNF and Risk of Recurrent...

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Slide Source: Lipids Online www.lipidsonline.org Plasma Concentration of TNF- Plasma Concentration of TNF- α α  and Risk of   and Risk of  Recurrent Coronary Events Recurrent Coronary Events 2.5 2.0 1.5 1.0 0–2.47 (1 st –50 th ) Relative Risk TNF- α  Concentration, pg/mL  (percentile of control distribution) 2.48–3.05 (51 st –75 th ) 3.06–4.17 (76 th –95 th ) 4.18+ (>95 th )
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Slide Source: Lipids Online www.lipidsonline.org Predictive Value of CRP and Other Inflammatory  Predictive Value of CRP and Other Inflammatory  Markers:  LDL <130 mg/dL Markers:  LDL <130 mg/dL 4 3 2 1 1 Relative Risk of Future Coronary Events Quartile of Inflammatory Marker hs-CRP 2 3 4 SAA IL-6 sICAM-1
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Slide Source: Lipids Online www.lipidsonline.org Age-Adjusted Correlation Coefficients for hs- Age-Adjusted Correlation Coefficients for hs- CRP Levels and Lipid Parameters over a 5-Year  CRP Levels and Lipid Parameters over a 5-Year  Follow-up Period Follow-up Period Parameter r P hs-CRP 0.60 0.001 Total Cholesterol 0.37 0.001 LDL-C 0.32 0.001 HDL-C 0.74 0.001 Triglycerides 0.49 0.001
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Slide Source: Lipids Online www.lipidsonline.org Population Distribution of hs-CRP in Apparently  Population Distribution of hs-CRP in Apparently  Healthy American Men and Women Healthy American Men and Women Quintile Range (mg/dL) Risk Estimate 1 0.01–0.069 Low 2 0.07–0.11 Mild 3 0.12–0.19 Moderate 4 0.20–0.38 High 5 0.39–1.50 Highest
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Slide Source: Lipids Online www.lipidsonline.org Assessment of the Clinical Utility of Novel  Assessment of the Clinical Utility of Novel  Markers of Cardiovascular Risk Markers of Cardiovascular Risk Marker Marker Assay Conditions  Assay Conditions  Standardized? Standardized? Prospective  Prospective  Studies  Studies  Consistent? Consistent? Additive to TC  Additive to TC  and HDL-C? and HDL-C? Lp(a) +/– +/– Homocysteine + +/– +/– tPA and PAI-1 +/– + +/– Fibrinogen +/– + + hs-CRP + + +
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Slide Source: Lipids Online www.lipidsonline.org Is there clinical evidence that inflammation can  Is there clinical evidence that inflammation can  be modified by preventive therapies? be modified by preventive therapies?
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Slide Source: Lipids Online www.lipidsonline.org 0 1 2 3 4 5 hs-CRP, Aspirin, and Risks of Future MI:  hs-CRP, Aspirin, and Risks of Future MI:  Physicians'  Physicians'  Health Study Health Study Quartile of C-Reactive Protein 1 2 3 4 Aspirin Placebo Relative Risk of MI
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Slide Source: Lipids Online www.lipidsonline.org Low-Dose Aspirin Reduces Thromboxane B Low-Dose Aspirin Reduces Thromboxane B 2 2  but   but  not CRP not CRP Serum CRP  (% of Baseline) 140 120 100 80 60 40 20 0 Placebo (n=11) 140 120 100 80 60 40 20 0 Serum Thromboxane  ASA 81 mg qd (n=13) Placebo (n=11) ASA 81 mg qd (n=13) 28 Days 31 Days * p<0.001 *  *
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This note was uploaded on 02/23/2012 for the course PHARM 290 taught by Professor Staff during the Fall '10 term at Rutgers.

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5341 - Plasma Concentration of TNF and Risk of Recurrent...

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