C-reactive protein and incidence of symptomatic peripheral vascular disease (sPVD): Findings from the multi-ethnic study of atherosclerosis (MESA).

Early identification of individuals at risk for symptomatic peripheral vascular disease (sPVD), including abdominal aortic aneurysm (AAA) and peripheral artery disease (PAD), is essential to reduce the substantial burden of associated morbidity and mortality. Given the central role of systemic inflammation in the pathogenesis and progression of atherosclerosis, we prospectively evaluated high sensitivity C-reactive protein (CRP) as a potential predictive biomarker for the long-term development of these specific vascular conditions within a large, population-based cohort free of baseline cardiovascular disease. Among 6161 participants followed over a median of 10.0 years, elevated CRP at or above 2.0 mg/L was independently associated with a more than two-fold higher incidence of sPVD after adjustment for traditional risk factors (HR 2.70; 95% CI 1.64 to 4.43; p < 0.001). Collectively, these findings suggest that elevated CRP might be an independent marker of long-term peripheral vascular risk and support further investigation of its role in primary prevention risk stratification.