title: Inflammation-sensitive plasma proteins and incidence of myocardial infarction in men with low cardiovascular risk.
abstract: OBJECTIVE
  Myocardial infarction (MI) is sometimes experienced by individuals without any traditional risk factor. This prospective study explored whether incidence of MI in nonsmoking, nondiabetic men with normal blood pressure and serum lipids is related to inflammation-sensitive plasma proteins (ISPs).
  
  
  RESULTS
  Five ISPs (alpha1-antitrypsin, haptoglobin, ceruloplasmin, fibrinogen, orosomucoid) were analyzed in 6075 men, 47+/-3.6 years old. A low-risk group (no traditional risk factor, n=1108) and a high-risk group (> or =2 major risk factors, n=1011) were defined. Incidence of MI (n=227) was monitored over 18.1+/-4.3 years of follow-up. In the low-risk group, the age-adjusted relative risks (RRs) were 1.00 (reference), 1.9 (95% CI, 0.8 to 4.2), 1.8 (95% CI, 0.6 to 5.4), and 2.9 (95% CI, 1.05 to 8.1), respectively, for men with 0, 1, 2 and > or =3 ISPs in the top quartile (trend: P=0.03). In this group, the increased risk was observed only after > or =10 years of follow-up. In the high-risk group, the age-adjusted RRs were 1.00, 1.4 (95% CI, 0.9 to 2.2), 1.9 (95% CI, 1.2 to 3.1), and 2.0 (95% CI, 1.3 to 3.1), respectively, for men with 0, 1, 2, and > or =3 ISPs in the top quartile (trend: P=0.0004).
  
  
  CONCLUSIONS
  Incidence of MI in nonsmoking, nondiabetic men with normal blood pressure and lipids was related to ISPs. The causes for this relationship remain to be explored.
authors.affiliation: Department of Community Medicine, Malmö University Hospital, S-20502 Malmö, Sweden. Gunnar.Engstrom@smi.mas.lu.se
authors.forename: Gunnar
authors.initials: G
authors.lastname: Engström
authors.forename: Lars
authors.initials: L
authors.lastname: Stavenow
authors.forename: Bo
authors.initials: B
authors.lastname: Hedblad
authors.forename: Peter
authors.initials: P
authors.lastname: Lind
authors.forename: Patrik
authors.initials: P
authors.lastname: Tydén
authors.forename: Lars
authors.initials: L
authors.lastname: Janzon
authors.forename: Folke
authors.initials: F
authors.lastname: Lindgärde
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D002570:Ceruloplasmin / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006242:Haptoglobins / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology*; D009961:Orosomucoid / Q000378:metabolism; D012307:Risk Factors; D000515:alpha 1-Antitrypsin / Q000378:metabolism
chemical_list: D000209:Acute-Phase Proteins; D006242:Haptoglobins; D009961:Orosomucoid; D000515:alpha 1-Antitrypsin; D005340:Fibrinogen; D002570:Ceruloplasmin