Objectives:

This study aimed to examine the association of high-sensitivity C reactive protein (hsCRP) with mortality risk and the attenuated effect of non-communicable disease history (NCD _history ) on the association.

Design:

Prospective cohort study.

Setting:

Health Examinees cohort.

Participants:

A total of 41 070 men and 81 011 women aged ≥40 years were involved (follow-up: 6.8 years).

Outcome measures:

Data and cause of death occurring until 31 December 2015 were confirmed by death statistics from the National Statistical Office. We conducted advanced analysis after stratification by NCD _history and sensitivity analysis after excluding death before 1 or 2 years from recruitment. Cox proportional hazard and restricted cubic spline models were used to assess the association.

Results:

The association between serum hsCRP and risk of all-cause mortality was observed with strong linearity in both genders and was not influenced by NCD _history . The association of serum hsCRP with risk of cancer mortality was not observed in women with NCD _history , but the association with risk of cardiovascular disease (CVD) mortality was predominantly observed in men with NCD _history .

Conclusions:

This study suggests a dose-response association of hsCRP with mortality risk, including cancer and CVD mortality, in Koreans with low serum hsCRP, although the association with cancer and CVD mortality risk could be influenced by gender and NCD _history .