ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
Systemic inflammation in people with ASCVD and CKD
Jan Håkon Rudolfsen 1
Jelena Vukmirica 2
Pierre Johansen 2
Kasper Løwe Lundgren 1
Martin Bødtker Mortensen 3,4
1. EY-Parthenon, Copenhagen, Denmark
2. Novo Nordisk Denmark A/S, Copenhagen, Denmark
3. Hjertesygdomme, Aarhus Universitet Institut for Klinisk Medicin, Aarhus, Denmark
4. Department of Cardiology, Johns Hopkins University, Baltimore, United States
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Abstract
Aims Systemic inflammation (SI), indicated by elevated C-reactive protein (CRP) levels, is known to increase the risk of major adverse cardiovascular events (MACE) and mortality. This study aims to investigate the association between SI and mortality in the Danish population diagnosed with atherosclerotic cardiovascular disease ASCVD and chronic kidney disease CKD. Methods: We identified 19,159 individuals with incident ASCVD and CKD between 2012 and 2022 in Danish national health registers. SI was defined by at least two CRP measurements between 2mg/L and 20mg/L within a six-month period. Cox proportional hazards models were employed to assess the relationship between SI and mortality, adjusting for relevant confounders. Results: Among the cohort, 68% were observed with SI. SI were associated with significantly higher risk of mortality, with a hazard ratio (HR) of 2.06 (95% CI: 1.92–2.21) for death and 1.66 (95% CI: 1.57–1.77) for 'MACE or death'. The results were consistent in all subgroup analyses and sensitivity analyses, including in men and women separately, and using different definitions of SI. Conclusion: This study demonstrates that SI is prevalent among patients with ASCVD and CKD being strongly associated with higher risk of mortality and MACE. These findings suggest that SI could serve as a valuable marker to identify patients with ASCVD and CKD who are at particularly high risk and may benefit from targeted preventive interventions.
Summary
Keywords
AtheroscleroticCardiovascular Disease, cardiovascular disease, Chronic Kidney Disease, C-Reactive Protein, Inflammation
Received
19 November 2025
Accepted
13 February 2026
Copyright
© 2026 Rudolfsen, Vukmirica, Johansen, Lundgren and Mortensen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Kasper Løwe Lundgren
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