Association Between High-sensitivity C-reactive Protein and Predicted Cardiovascular Risks in Schizophrenia

Context . Cardiovascular disease (CVD) is one of the main causes of premature death in patients with schizophrenia. High-sensitivity C-reactive protein (hs-CRP) is closely related to various risk factors of CVD in the general population and is a sensitive marker of subclinical inflammation. Objectives . The study intended to evaluate the predictive value of hs-CRP for high cardiovascular risk in patients with schizophrenia. Design . The research team designed a cross-sectional retrospective study. Setting . The study took place at the Affiliated Brain Hospital of Guangzhou Medical University in Guangzhou, Guangdong Province, China. Participants . Participants were 387 patients with schizophrenia who had been admitted to the inpatient clinic at the hospital between January 1, 2018 and December 30, 2019. Outcome Measures . The research team: (1) measured participants' hs-CRP and calculated the 10-year general cardiovascular risk, with a risk of >20% being defined as a high risk; (2) compared participants' demographics and traditional cardiovascular risk factors, and the prevalence of high cardiovascular risk according to the hs-CRP quartile; (3) used the receiver operating characteristic (ROC) curves to determine the optimal cutoff value for hs-CRP to predict high cardiovascular risk; and (4) used multivariate logistic regression analysis to assess the association between hs-CRP and high cardiovascular risk. Results . Of the 387 participants, 23 had a high cardiovascular risk (5.9%). The prevalence of high cardiovascular risk in quartiles Q1, Q2, Q3, and Q4 groups was 0%, 2.0%, 12.5%, and 9.4%, respectively, with a P trend <.001. The ROC analysis showed that an hs-CRP cutoff value of 2.13mg/L was a fair discriminator for high cardiovascular risk, with a C statistic of 0.74. After adjusting confounding factors by multivariate logistic regression analysis, an hs-CRP of >= 2.13 mg/L was significantly associated with high cardiovascular risk (OR = 7.81, 95% CI: 1.73 - 35.39, P =.008). Conclusions . An hs-CRP of >= 2.13 mg/L can be an independent predictor of high cardiovascular risk in patients with schizophrenia. Detection of hs-CRP may be beneficial in identifying patients at high risk of cardiovascular events in this population. Further prospective studies are needed to determine the hs-CRP threshold for evaluating cardiovascular risk in schizophrenia.