Prevalence and clinical characteristics of patients with hsCRP testing and test-confirmed systemic inflammation among individuals with atherosclerotic cardiovascular disease with or without chronic kidney disease in the United States (PLUTUS)

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-02-19 DOI:10.1016/j.ajpc.2025.100950

Lei Lv , Jigar Rajpura , Meixia Liu , Matt Strum , Benjamin Chastek , Jonathan Johnson , Ty J. Gluckman

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Abstract

Background

Systemic inflammation (SI) is a risk factor for atherosclerotic cardiovascular disease (ASCVD) and is most commonly assessed by measuring levels of high-sensitivity C-reactive protein (hsCRP).

Objective

This study aimed to determine hsCRP testing rates and SI prevalence in patients with ASCVD and in a subset of patients with chronic kidney disease (CKD).

Methods

This was a retrospective, cross-sectional analysis using US-based data from the Optum® de-identified Electronic Health Record data set (Optum® EHR; 1/1/2017–12/31/2021). hsCRP testing rates and SI prevalence (hsCRP ≥2 to <10 mg/L) were evaluated by calendar year. Demographics, comorbidities, and treatment patterns were compared between patients with ASCVD, ASCVD + CKD, and ASCVD + stage 3/4 CKD, with and without SI.

Results

1,658,476 patients with ASCVD were eligible for study inclusion. Per calendar year, 44.9 %-68.8 % and 14.9 %-18.9 % of patients had any CKD and stage 3/4 CKD, respectively. hsCRP testing was performed in 0.87 %-0.98 % (ASCVD), 0.90 %-1.17 % (ASCVD + CKD), and 0.99 %-1.41 % (ASCVD + stage 3/4 CKD) of patients. SI was present in 37.16 %-38.62 % (ASCVD), 40.61 %-44.44 % (ASCVD + CKD), and 49.44 %-53.92 % (ASCVD + stage 3/4 CKD) of tested patients. Among those with SI, patients with CKD had a greater comorbidity burden than those without.

Conclusion

While rates of hsCRP testing were low in patients with ASCVD, the prevalence of SI was high in hsCRP-tested patients with ASCVD, irrespective of CKD presence or severity. Given the low rate of testing, patients with SI may not be identified and treated.

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