Multiple inflammatory biomarkers in relation to cardiovascular events and mortality in the community

Evidence suggests that chronic low-grade inflammation and oxidative stress are related to cardiovascular disease (CVD) and mortality. We examined 11 established and novel biomarkers representing inflammation and oxidative stress (C-reactive protein, fibrinogen, interleukin-6, intercellular adhesion...

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Published in:Arteriosclerosis, thrombosis, and vascular biology Vol. 33; no. 7; p. 1728
Main Authors: Schnabel, Renate B, Yin, Xiaoyan, Larson, Martin G, Yamamoto, Jennifer F, Fontes, João D, Kathiresan, Sekar, Rong, Jian, Levy, Daniel, Keaney, Jr, John F, Wang, Thomas J, Murabito, Joanne M, Vasan, Ramachandran S, Benjamin, Emelia J
Format: Journal Article
Language:English
Published: United States 01.07.2013
Subjects:
Aged
Biomarkers - blood
C-Reactive Protein - metabolism
Cardiovascular Diseases - blood
Cardiovascular Diseases - mortality
Disease-Free Survival
Female
Health Surveys
Humans
Incidence
Inflammation - blood
Inflammation - mortality
Inflammation Mediators - blood
Intercellular Adhesion Molecule-1 - blood
Interleukin-6 - blood
Male
Massachusetts - epidemiology
Middle Aged
Multivariate Analysis
Principal Component Analysis
Prognosis
Proportional Hazards Models
Receptors, Tumor Necrosis Factor, Type II - blood
Risk Assessment
Risk Factors
Time Factors
Massachusetts
mortality
cardiovascular disease
epidemiology
cohort
inflammation
ISSN:1524-4636, 1524-4636
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Summary:Evidence suggests that chronic low-grade inflammation and oxidative stress are related to cardiovascular disease (CVD) and mortality. We examined 11 established and novel biomarkers representing inflammation and oxidative stress (C-reactive protein, fibrinogen, interleukin-6, intercellular adhesion molecule-1, lipoprotein-associated phospholipase-A2 [mass and activity], monocyte chemoattractant protein-1, myeloperoxidase, CD40 ligand, P-selectin, and tumor necrosis factor receptor II [TNFRII]) in relation to incident major CVD and mortality in the community. We studied 3035 participants (mean age, 61 ± 9 years; 53% women). During follow-up (median, 8.9 years), 253 participants experienced a CVD event and 343 died. C-reactive protein (hazard ratio [HR] reported per SD ln-transformed biomarker, 1.18; 95% confidence interval [CI], 1.02-1.35; nominal P=0.02) and TNFRII (HR, 1.15; 95% CI, 1.01-1.32; nominal P=0.04) were retained in multivariable-adjusted models for major CVD, but were not significant after adjustment for multiple testing. The biomarkers related to mortality were TNFRII (HR, 1.33; 95% CI, 1.19-1.49; P<0.0001), ICAM-1 (HR, 1.24; 95% CI, 1.12-1.37; P<0.0001), and interleukin-6 (HR, 1.25; 95% CI, 1.12-1.39; P<0.0001). The addition of these markers to the model, including traditional risk factors, increased discrimination and reclassification for risk of death (P<0.0001), but not for CVD. Of 11 inflammatory biomarkers tumor necrosis factor receptor II was related to cardiovascular disease and mortality in the Framingham Heart Study. The combination of TNFRII with C-reactive protein in relation to CVD and with interleukin-6 to mortality increased the predictive ability in addition to CVD risk factors for total mortality but not for incident CVD.
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ISSN:1524-4636
1524-4636
DOI:10.1161/ATVBAHA.112.301174