title: Macrophage migration inhibitory factor and the risk of myocardial infarction or death due to coronary artery disease in adults without prior myocardial infarction or stroke: the EPIC-Norfolk Prospective Population study.
abstract: OBJECTIVE
  To determine whether plasma levels of macrophage migration inhibitory factor, a proinflammatory cytokine involved in atherogenesis, are predictive of myocardial infarction or death from coronary artery disease.
  
  
  METHODS
  We performed a prospective case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort. We selected men and women who did not report a history of myocardial infarction or stroke at baseline. Baseline concentrations of macrophage migration inhibitory factor were measured among 777 patients who had a myocardial infarction or died of coronary artery disease during follow-up, and 1554 matched controls who remained free of coronary artery disease.
  
  
  RESULTS
  Baseline macrophage migration inhibitory factor concentrations were higher in cases than controls (median, 107.4 microg/L vs. 90.7 microg/L, P = 0.001). The risk of myocardial infarction or death from coronary artery disease increased with increasing quartiles of macrophage migration inhibitory factor (P for linearity <0.0001). Patients in the highest quartile had the greatest likelihood of myocardial infarction or death due to coronary artery disease (unadjusted odds ratio [OR] = 1.6; 95% confidence interval [CI]: 1.2 to 2.0). After adjustment for traditional risk factors and C-reactive protein level, the odds ratio decreased slightly (OR = 1.3; 95% CI: 1.0 to 1.7). Upon additional adjustment for white cell count, this association was no longer statistically significant.
  
  
  CONCLUSIONS
  Prospective data suggest that the relation between macrophage migration inhibitory factor and the risk of myocardial infarction or death due to coronary artery disease in adults without a history of myocardial infarction or stroke is not very strong. However, the data support a regulatory role for macrophage migration inhibitory factor in the process of atherosclerosis.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The netherlands.
authors.forename: S Matthijs
authors.initials: SM
authors.lastname: Boekholdt
authors.forename: Ron J G
authors.initials: RJ
authors.lastname: Peters
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Day
authors.forename: Robert
authors.initials: R
authors.lastname: Luben
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Bingham
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: C Erik
authors.initials: CE
authors.lastname: Hack
authors.forename: Pieter H
authors.initials: PH
authors.lastname: Reitsma
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008263:Macrophage Migration-Inhibitory Factors / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000378:metabolism*; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008263:Macrophage Migration-Inhibitory Factors; D002097:C-Reactive Protein