C-reactive protein, interleukin-6, and fibrinogen as predictors of coronary heart disease: the PRIME Study.
OBJECTIVE
This study was undertaken to examine the association of plasma inflammatory markers such as C-reactive protein (CRP), interleukin-6, and fibrinogen with the incidence of coronary heart disease within the prospective cohort study on myocardial infarction (PRIME study).


RESULTS
Multiple risk factors were recorded at baseline in 9758 men aged 50 to 59 years who were free of coronary heart disease (CHD) on entry. Nested case-control comparisons were carried out on 317 participants who suffered myocardial infarction (MI)-coronary death (n=163) or angina (n=158) as an initial CHD event during a follow-up for 5 years. After adjustment for traditional risk factors, incident MI-coronary death, but not angina, was significantly associated with CRP, interleukin-6, and fibrinogen, but only interleukin-6 remained significantly associated with MI-coronary death when the 3 inflammatory markers were included in the model. The different interleukin-6 levels in Northern Ireland and France partly explained the difference in risk between these countries. Interleukin-6 appeared as a risk marker of MI-coronary death, and it improved the definition of CHD risk beyond LDL cholesterol.


CONCLUSIONS
This association may reflect the underlying inflammatory reaction located in the atherosclerotic plaque or a genetic susceptibility on the part of CHD subjects to answer a proinflammatory stimulus and subsequent increase in hepatic CRP gene expression.
Luc
Gérald
G
Department of Atherosclerosis, SERLIA-INSERM UR545, Institut Pasteur de Lille and University Lille II, 1 Rue du Professeur Calmette, 59019 Lille Cedex, France. Gerald.Luc@pasteur-lille.fr
Bard
Jean-Marie
JM
Juhan-Vague
Irène
I
Ferrieres
Jean
J
Evans
Alun
A
Amouyel
Philippe
P
Arveiler
Dominique
D
Fruchart
Jean-Charles
JC
Ducimetiere
Pierre
P
D000787:Angina Pectoris / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis*; D016757:Death, Sudden, Cardiac; D005340:Fibrinogen / Q000032:analysis*; D005602:France; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D009660:Northern Ireland; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
D015415:Biomarkers; D015850:Interleukin-6; D005340:Fibrinogen; D002097:C-Reactive Protein