Are markers of inflammation more strongly associated with risk for fatal than for nonfatal vascular events?

Hdl Handle:
http://hdl.handle.net/10147/200987
Title:
Are markers of inflammation more strongly associated with risk for fatal than for nonfatal vascular events?
Authors:
Sattar, Naveed; Murray, Heather M; Welsh, Paul; Blauw, Gerard J; Buckley, Brendan M; Cobbe, Stuart; de Craen, Anton J M; Lowe, Gordon D; Jukema, J Wouter; Macfarlane, Peter W; Murphy, Michael B; Stott, David J; Westendorp, Rudi G J; Shepherd, James; Ford, Ian; Packard, Chris J
Affiliation:
Division of Cardiovascular and Medical Sciences, Faculty of Medicine, University of Glasgow, Glasgow, Scotland, UK. nsattar@clinmed.gla.ac.uk
Citation:
Are markers of inflammation more strongly associated with risk for fatal than for nonfatal vascular events? 2009, 6 (6):e1000099 PLoS Med.
Journal:
PLoS medicine
Issue Date:
23-Jun-2009
URI:
http://hdl.handle.net/10147/200987
DOI:
10.1371/journal.pmed.1000099
PubMed ID:
19554082
Additional Links:
BACKGROUND: Circulating inflammatory markers may more strongly relate to risk of fatal versus nonfatal cardiovascular disease (CVD) events, but robust prospective evidence is lacking. We tested whether interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen more strongly associate with fatal compared to nonfatal myocardial infarction (MI) and stroke.; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2694359/pdf/pmed.1000099.pdf
Abstract:
Circulating inflammatory markers may more strongly relate to risk of fatal versus nonfatal cardiovascular disease (CVD) events, but robust prospective evidence is lacking. We tested whether interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen more strongly associate with fatal compared to nonfatal myocardial infarction (MI) and stroke.; In the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), baseline inflammatory markers in up to 5,680 men and women aged 70-82 y were related to risk for endpoints; nonfatal CVD (i.e., nonfatal MI and nonfatal stroke [n = 672]), fatal CVD (n = 190), death from other CV causes (n = 38), and non-CVD mortality (n = 300), over 3.2-y follow-up. Elevations in baseline IL-6 levels were significantly (p = 0.0009; competing risks model analysis) more strongly associated with fatal CVD (hazard ratio [HR] for 1 log unit increase in IL-6 1.75, 95% confidence interval [CI] 1.44-2.12) than with risk of nonfatal CVD (1.17, 95% CI 1.04-1.31), in analyses adjusted for treatment allocation. The findings were consistent in a fully adjusted model. These broad trends were similar for CRP and, to a lesser extent, for fibrinogen. The results were also similar in placebo and statin recipients (i.e., no interaction). The C-statistic for fatal CVD using traditional risk factors was significantly (+0.017; p<0.0001) improved by inclusion of IL-6 but not so for nonfatal CVD events (p = 0.20).; In PROSPER, inflammatory markers, in particular IL-6 and CRP, are more strongly associated with risk of fatal vascular events than nonfatal vascular events. These novel observations may have important implications for better understanding aetiology of CVD mortality, and have potential clinical relevance.
Item Type:
Article
Language:
en
Description:
BACKGROUND: Circulating inflammatory markers may more strongly relate to risk of fatal versus nonfatal cardiovascular disease (CVD) events, but robust prospective evidence is lacking. We tested whether interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen more strongly associate with fatal compared to nonfatal myocardial infarction (MI) and stroke. METHODS AND FINDINGS: In the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), baseline inflammatory markers in up to 5,680 men and women aged 70-82 y were related to risk for endpoints; nonfatal CVD (i.e., nonfatal MI and nonfatal stroke [n = 672]), fatal CVD (n = 190), death from other CV causes (n = 38), and non-CVD mortality (n = 300), over 3.2-y follow-up. Elevations in baseline IL-6 levels were significantly (p = 0.0009; competing risks model analysis) more strongly associated with fatal CVD (hazard ratio [HR] for 1 log unit increase in IL-6 1.75, 95% confidence interval [CI] 1.44-2.12) than with risk of nonfatal CVD (1.17, 95% CI 1.04-1.31), in analyses adjusted for treatment allocation. The findings were consistent in a fully adjusted model. These broad trends were similar for CRP and, to a lesser extent, for fibrinogen. The results were also similar in placebo and statin recipients (i.e., no interaction). The C-statistic for fatal CVD using traditional risk factors was significantly (+0.017; p<0.0001) improved by inclusion of IL-6 but not so for nonfatal CVD events (p = 0.20). CONCLUSIONS: In PROSPER, inflammatory markers, in particular IL-6 and CRP, are more strongly associated with risk of fatal vascular events than nonfatal vascular events. These novel observations may have important implications for better understanding aetiology of CVD mortality, and have potential clinical relevance.
MeSH:
Aged; Aged, 80 and over; Anticholesteremic Agents; Biological Markers; C-Reactive Protein; Female; Fibrinogen; Humans; Inflammation; Interleukin-6; Kaplan-Meier Estimate; Male; Myocardial Infarction; Pravastatin; Risk Factors; Stroke
ISSN:
1549-1676

Full metadata record

DC FieldValue Language
dc.contributor.authorSattar, Naveeden
dc.contributor.authorMurray, Heather Men
dc.contributor.authorWelsh, Paulen
dc.contributor.authorBlauw, Gerard Jen
dc.contributor.authorBuckley, Brendan Men
dc.contributor.authorCobbe, Stuarten
dc.contributor.authorde Craen, Anton J Men
dc.contributor.authorLowe, Gordon Den
dc.contributor.authorJukema, J Wouteren
dc.contributor.authorMacfarlane, Peter Wen
dc.contributor.authorMurphy, Michael Ben
dc.contributor.authorStott, David Jen
dc.contributor.authorWestendorp, Rudi G Jen
dc.contributor.authorShepherd, Jamesen
dc.contributor.authorFord, Ianen
dc.contributor.authorPackard, Chris Jen
dc.date.accessioned2012-01-09T16:53:51Z-
dc.date.available2012-01-09T16:53:51Z-
dc.date.issued2009-06-23-
dc.identifier.citationAre markers of inflammation more strongly associated with risk for fatal than for nonfatal vascular events? 2009, 6 (6):e1000099 PLoS Med.en
dc.identifier.issn1549-1676-
dc.identifier.pmid19554082-
dc.identifier.doi10.1371/journal.pmed.1000099-
dc.identifier.urihttp://hdl.handle.net/10147/200987-
dc.descriptionBACKGROUND: Circulating inflammatory markers may more strongly relate to risk of fatal versus nonfatal cardiovascular disease (CVD) events, but robust prospective evidence is lacking. We tested whether interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen more strongly associate with fatal compared to nonfatal myocardial infarction (MI) and stroke. METHODS AND FINDINGS: In the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), baseline inflammatory markers in up to 5,680 men and women aged 70-82 y were related to risk for endpoints; nonfatal CVD (i.e., nonfatal MI and nonfatal stroke [n = 672]), fatal CVD (n = 190), death from other CV causes (n = 38), and non-CVD mortality (n = 300), over 3.2-y follow-up. Elevations in baseline IL-6 levels were significantly (p = 0.0009; competing risks model analysis) more strongly associated with fatal CVD (hazard ratio [HR] for 1 log unit increase in IL-6 1.75, 95% confidence interval [CI] 1.44-2.12) than with risk of nonfatal CVD (1.17, 95% CI 1.04-1.31), in analyses adjusted for treatment allocation. The findings were consistent in a fully adjusted model. These broad trends were similar for CRP and, to a lesser extent, for fibrinogen. The results were also similar in placebo and statin recipients (i.e., no interaction). The C-statistic for fatal CVD using traditional risk factors was significantly (+0.017; p<0.0001) improved by inclusion of IL-6 but not so for nonfatal CVD events (p = 0.20). CONCLUSIONS: In PROSPER, inflammatory markers, in particular IL-6 and CRP, are more strongly associated with risk of fatal vascular events than nonfatal vascular events. These novel observations may have important implications for better understanding aetiology of CVD mortality, and have potential clinical relevance.en
dc.description.abstractCirculating inflammatory markers may more strongly relate to risk of fatal versus nonfatal cardiovascular disease (CVD) events, but robust prospective evidence is lacking. We tested whether interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen more strongly associate with fatal compared to nonfatal myocardial infarction (MI) and stroke.-
dc.description.abstractIn the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), baseline inflammatory markers in up to 5,680 men and women aged 70-82 y were related to risk for endpoints; nonfatal CVD (i.e., nonfatal MI and nonfatal stroke [n = 672]), fatal CVD (n = 190), death from other CV causes (n = 38), and non-CVD mortality (n = 300), over 3.2-y follow-up. Elevations in baseline IL-6 levels were significantly (p = 0.0009; competing risks model analysis) more strongly associated with fatal CVD (hazard ratio [HR] for 1 log unit increase in IL-6 1.75, 95% confidence interval [CI] 1.44-2.12) than with risk of nonfatal CVD (1.17, 95% CI 1.04-1.31), in analyses adjusted for treatment allocation. The findings were consistent in a fully adjusted model. These broad trends were similar for CRP and, to a lesser extent, for fibrinogen. The results were also similar in placebo and statin recipients (i.e., no interaction). The C-statistic for fatal CVD using traditional risk factors was significantly (+0.017; p<0.0001) improved by inclusion of IL-6 but not so for nonfatal CVD events (p = 0.20).-
dc.description.abstractIn PROSPER, inflammatory markers, in particular IL-6 and CRP, are more strongly associated with risk of fatal vascular events than nonfatal vascular events. These novel observations may have important implications for better understanding aetiology of CVD mortality, and have potential clinical relevance.-
dc.language.isoenen
dc.relation.urlBACKGROUND: Circulating inflammatory markers may more strongly relate to risk of fatal versus nonfatal cardiovascular disease (CVD) events, but robust prospective evidence is lacking. We tested whether interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen more strongly associate with fatal compared to nonfatal myocardial infarction (MI) and stroke.en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2694359/pdf/pmed.1000099.pdfen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAnticholesteremic Agents-
dc.subject.meshBiological Markers-
dc.subject.meshC-Reactive Protein-
dc.subject.meshFemale-
dc.subject.meshFibrinogen-
dc.subject.meshHumans-
dc.subject.meshInflammation-
dc.subject.meshInterleukin-6-
dc.subject.meshKaplan-Meier Estimate-
dc.subject.meshMale-
dc.subject.meshMyocardial Infarction-
dc.subject.meshPravastatin-
dc.subject.meshRisk Factors-
dc.subject.meshStroke-
dc.titleAre markers of inflammation more strongly associated with risk for fatal than for nonfatal vascular events?en
dc.typeArticleen
dc.contributor.departmentDivision of Cardiovascular and Medical Sciences, Faculty of Medicine, University of Glasgow, Glasgow, Scotland, UK. nsattar@clinmed.gla.ac.uken
dc.identifier.journalPLoS medicineen
dc.description.provinceMunster-

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