Number of cause-specific deaths, HRs for cause-specific death of CVD and its subtypes according to hs-CRP levels
| Diagnosis at the emergency department | Total | hs-CRP levels (mg/L) | p for trend (across categories) | Continuous log scale | p for trend (continuous) | ||||
| <3.0 | 3.1–5.4 | 5.5–11.5 | 11.6–33.2 | ≥33.3 | |||||
| CVD | |||||||||
| No of patients | 12 211 | 7375 | 1212 | 1200 | 1216 | 1208 | |||
| No of CVD deaths | 976 | 484 | 106 | 116 | 120 | 150 | |||
| CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 1.16 (0.94 to 1.43) | 1.23 (1.00 to 1.51) | 1.20 (0.98 to 1.46) | 1.44* (1.20 to 1.73) | <0.001 | 1.08* (1.03 to 1.11) | <0.001 | |
| CVD-related, Age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 1.13 (0.92 to 1.40) | 1.20 (1.00 to 1.48) | 1.16 (0.95 to 1.42) | 1.33* (1.10 to 1.61) | 0.002 | 1.05* (1.01 to 1.09) | 0.004 | |
| No of non-CVD deaths | 180 | 33 | 10 | 18 | 29 | 90 | |||
| Non-CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 1.55 (0.76 to 3.15) | 2.67* (1.50 to 4.75) | 3.84* (2.32 to 6.35) | 12.05* (8.05 to 18.04) | <0.001 | 1.77* (1.63 to 1.93) | <0.001 | |
| Non-CVD-related, age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 1.52 (0.75 to 3.09) | 2.61* (1.47 to 4.65) | 3.72* (2.25 to 6.16) | 11.49* (7.66 to 17.23) | <0.001 | 1.75* (1.61 to 1.91) | <0.001 | |
| Acute myocardial infarction | |||||||||
| No of patients | 1347 | 796 | 145 | 126 | 125 | 155 | |||
| No of CVD deaths | 70 | 25 | 2 | 11 | 7 | 25 | |||
| CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 0.37 (0.09 to 1.56) | 1.93 (0.94 to 3.95) | 1.31 (0.56 to 3.05) | 3.51* (1.98 to 6.23) | <0.001 | 1.30* (1.14 to 1.48) | <0.001 | |
| CVD-related, age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 0.35 (0.08 to 1.47) | 1.74 (0.85 to 3.58) | 1.01 (0.41 to 2.47) | 2.71* (1.50 to 4.90) | 0.001 | 1.23* (1.08 to 1.40) | 0.002 | |
| No of non-CVD deaths | 19 | 3 | 2 | 1 | 2 | 11 | |||
| Non-CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 2.82 (0.47 to 17.04) | 1.21 (0.12 to 11.75) | 2.59 (0.42 to 15.84) | 10.14* (2.75 to 37.33) | <0.001 | 1.73* (1.32 to 2.28) | <0.001 | |
| Non-CVD-related, age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 2.71 (0.45 to 16.45) | 1.11 (0.11 to 10.81) | 2.07 (0.31 to 13.72) | 8.64* (2.32 to 32.27) | 0.001 | 1.67* (1.27 to 2.21) | <0.001 | |
| Heart failure | |||||||||
| No of patients | 1742 | 620 | 232 | 249 | 310 | 331 | |||
| No of CVD deaths | 98 | 15 | 10 | 21 | 19 | 33 | |||
| CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 1.49 (0.67 to 3.33) | 2.27 (1.14 to 4.51) | 1.76 (0.88 to 3.48) | 2.58* (1.39 to 4.79) | 0.004 | 1.23* (1.09 to 1.39) | 0.001 | |
| CVD-related age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 1.49 (0.67 to 3.32) | 2.29 (1.15 to 4.56) | 1.78 (0.90 to 3.54) | 2.66* (1.42 to 4.97) | 0.003 | 1.24* (1.09 to 1.41) | 0.001 | |
| No of non-CVD deaths | 50 | 4 | 1 | 7 | 10 | 28 | |||
| Age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 0.52 (0.06 to 4.68) | 2.50 (0.72 to 8.74) | 2.92 (0.91 to 9.42) | 6.80* (2.36 to 19.57) | <0.001 | 1.69* (1.38 to 2.08) | <0.001 | |
| Non-CVD-related, age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 0.51 (0.06 to 4.57) | 2.52 (0.72 to 8.80) | 3.21 (0.99 to 10.33) | 8.19* (2.82 to 23.80) | <0.001 | 1.84* (1.47 to 2.29) | <0.001 | |
| Cerebral infarction | |||||||||
| No of patients | 2879 | 1823 | 277 | 281 | 271 | 227 | |||
| No of CVD deaths | 230 | 103 | 22 | 33 | 38 | 34 | |||
| CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 1.08 (0.68 to 1.72) | 1.76 (1.19 to 2.61) | 1.95* (1.34 to 2.84) | 2.13* (1.44 to 3.14) | <0.001 | 1.21* (1.12 to 1.30) | <0.001 | |
| CVD-related age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 0.99 (0.62 to 1.57) | 1.59 (1.07 to 2.35) | 1.48 (1.00 to 2.19) | 1.44 (0.95 to 2.20) | 0.012 | 1.11 (1.03 to 1.21) | 0.008 | |
| No of non-CVD deaths | 31 | 6 | 3 | 1 | 5 | 16 | |||
| Non-CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 2.07 (0.51 to 8.41) | 0.92 (0.11 to 7.63) | 3.08 (0.91 to 10.49) | 18.78* (7.27 to 48.51) | <0.001 | 1.95* (1.57 to 2.41) | <0.001 | |
| Non-CVD-related age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 2.20 (0.54 to 8.99) | 0.99 (0.12 to 8.29) | 3.87 (1.10 to 13.62) | 24.08* (8.62 to 67.25) | <0.001 | 2.08* (1.65 to 2.64) | <0.001 | |
| Intracerebral haemorrhage | |||||||||
| No of patients | 1989 | 1428 | 167 | 153 | 137 | 104 | |||
| No of CVD deaths | 313 | 196 | 37 | 29 | 28 | 23 | |||
| CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 1.56 (1.10 to 2.22) | 1.25 (0.84 to 1.84) | 1.32 (0.88 to 1.97) | 1.49 (0.96 to 2.30) | 0.019 | 1.07 (1.00 to 1.14) | 0.061 | |
| CVD-related, age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 1.52 (1.07 to 2.17) | 1.23 (0.83 to 1.82) | 1.29 (0.86 to 1.92) | 1.30 (0.82 to 2.04) | 0.020 | 1.05 (0.98 to 1.13) | 0.166 | |
| No of non-CVD deaths | 25 | 5 | 2 | 3 | 1 | 14 | |||
| Non-CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 3.17 (0.62 to 16.37) | 5.13 (1.22 to 21.58) | 1.85 (0.21 to 16.09) | 32.57* (11.41 to 92.97) | <0.001 | 2.26* (1.78 to 2.86) | <0.001 | |
| Non-CVD-related age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 3.05 (0.59 to 15.77) | 4.97 (1.18 to 20.89) | 1.77 (0.20 to 15.38) | 28.22* (9.76 to 81.58) | <0.001 | 2.21* (1.73 to 2.81) | <0.001 | |
| Others | |||||||||
| No of patients | 4254 | 2708 | 391 | 391 | 373 | 391 | |||
| No of CVD deaths | 265 | 145 | 35 | 22 | 28 | 35 | |||
| CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 1.45 (1.00 to 2.11) | 0.83 (0.53 to 1.30) | 1.02 (0.67 to 1.54) | 1.01 (0.67 to 1.54) | 0.894 | 1.01 (0.95 to 1.08) | 0.750 | |
| CVD-related age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 1.32 (0.91 to 1.91) | 0.57 (0.35 to 0.93) | 0.77 (0.53 to 1.14) | 1.03 (1.02 to 1.04) | 0.119 | 0.96 (0.90 to 1.03) | 0.212 | |
| No of non-CVD deaths | 55 | 15 | 2 | 6 | 11 | 21 | |||
| Non-CVD-related age-adjusted and sex-adjusted HR (95% CI) | 1 (ref.) | 0.86 (0.20 to 3.76) | 2.08 (0.80 to 5.40) | 3.62* (1.63 to 8.05) | 4.87* (2.47 to 9.61) | <0.001 | 1.44* (1.25 to 1.65) | <0.001 | |
| Non-CVD-related age-adjusted, sex-adjusted and WCC-adjusted HR (95% CI) | 1 (ref.) | 0.90 (0.21 to 3.93) | 2.24 (0.86 to 5.85) | 3.87* (1.73 to 8.64) | 5.30* (2.66 to 10.54) | <0.001 | 1.47* (1.28 to 1.69) | <0.001 | |
*Statistically significant after applying a Bonferroni correction.
Acute myocardial infarction: ICD-10 (I21–I24); cerebral infarction: ICD-10 (I63); CVD: International Statistical Classification of Diseases and related problems 10th revision (below ICD-10) Diseases of the circulatory system (I00-I99); heart failure: ICD-10 (I50); intracerebral haemorrhage: ICD-10 (I61).
CVD, cardiovascular disease; hs-CRP, high-sensitivity C reactive protein; WCC, white cell count.