1. Slide Source: Lipids Online Slide Library www.lipidsonline.org C-Reactive Protein, Metabolic Syndrome, and Risk for CV Events: Women’s Health Study 14,719 women aged 45 years with no history of CVD, cancer, or diabetes and not using HRT at baseline Metabolic syndrome criteria definitions: – Obesity: BMI >26.7 kg/m 2 – Hypertriglyceridemia: TG 150 mg/dl – Low HDL-C: <50 mg/dl – Hypertension: 135/85 mm Hg – Impaired fasting glucose: diagnosis of incident type 2 diabetes during follow-up Elevated CRP defined as >3 mg/L Follow-up for cardiovascular events: 8 years Ridker PM et al. Circulation 2003;107:391–397.

2. Slide Source: Lipids Online Slide Library www.lipidsonline.org CRP Values by Each Component of Metabolic Syndrome: WHS Metabolic Syndrome Component Median CRP (Interquartile Range) p Metabolic Syndrome Present Metabolic Syndrome Absent BMI >26.7 kg/m 2 (n=5158) 3.13 (1.57–5.63) 0.95 (0.43–2.04) <.0001 TG 150 mg/dl (n=4297) 2.56 (1.24–4.84) 1.11 (0.48–2.57) <.0001 HDL-C <50 mg/dl (n=7572) 2.02 (0.88–4.26) 1.00 (0.44–2.31) <.0001 BP 135/85 mm Hg (n=4859) 2.38 (1.06–4.78) 1.14 (0.48–2.56) <.0001 IFG (Dx incident DM) (n=568) 4.30 (2.51–7.48) 1.39 (0.57–3.16) <.0001 3 components (n=3597) 3.38 (1.76–6.01) 1.08 (0.47–2.37) <.0001 Ridker PM et al. Circulation 2003;107:391–397.

3. Slide Source: Lipids Online Slide Library www.lipidsonline.org Number of Components of the Metabolic Syndrome C-Reactive Protein (mg/L) Distribution of CRP Levels by Number of Components of the Metabolic Syndrome: WHS Ridker PM et al. Circulation 2003;107:391–397. 012345 Box plots denote median and 25 th and 75 th percentile CRP values p-trend <.0001 n=4086 0.68 1.09 1.93 3.01 n=3884 3.88 5.75 n=3152 n=2292 n=1135 n=170

4. Slide Source: Lipids Online Slide Library www.lipidsonline.org CVD Event-Free Survival Probability Metabolic Syndrome No CVD Event–Free Survival by Metabolic Syndrome Status or CRP: WHS Ridker PM et al. Circulation 2003;107:391–397. Years of Follow-up 02468 CRP <3 mg/L CRP >3 mg/L Metabolic Syndrome Yes

5. Slide Source: Lipids Online Slide Library www.lipidsonline.org CVD Event-Free Survival Probability CVD Event–Free Survival Stratified by Both Metabolic Syndrome Status and CRP: WHS Ridker PM et al. Circulation 2003;107:391–397. Total Cohort (N=14,719) 02468 LDL <160 mg/dL (N=12,453) 02468 LDL <130 mg/dL (N=8,500) 02468 CRP <3 mg/L, No Metabolic Syndrome CRP 3 mg/L, No Metabolic Syndrome Years of Follow-up CRP <3 mg/L, Metabolic Syndrome CRP 3 mg/L, Metabolic Syndrome

6. Slide Source: Lipids Online Slide Library www.lipidsonline.org Relative Risk for CV Event by Metabolic Syndrome Status and CRP Level: WHS Ridker PM et al. Circulation 2003;107:391–397. Metabolic Syndrome Status CRP, mg/L All Cardiovascular Events (n=255) Coronary Events (n=163) in Total Cohort (n=14,719) Total Cohort (n=14,719) LDL <160 mg/dl (n=12,453) LDL <130 mg/dl (n=8500) Absent<31.0 Absent>31.5 (1.0–2.2) 1.3 (0.8–2.2) 1.2 (0.6–2.3) 1.6 (0.9–2.7) Present<32.3 (1.6–3.3) 2.2 (1.4–3.5) 2.5 (1.4–4.4) 3.1 (2.0–4.9) Present>34.0 (3.0–5.4) 4.4 (3.1–6.3) 4.4 (2.8–7.1) 5.5 (3.8–8.0)