Increased concentrations of C-reactive protein and IL-6 but not IL-18 are independently associated with incident coronary events in middle-aged men and women: results from the MONICA/KORA Augsburg case-cohort study, 1984-2002.
OBJECTIVE
We performed a prospective case-cohort study in initially healthy, middle-aged men and women from the MONICA/KORA Augsburg studies conducted between 1984 and 2002 to assess the role of IL-18 in comparison with IL-6 and CRP in the prediction of incident coronary heart disease (CHD).


RESULTS
Concentrations of IL-18 were measured in 382 case subjects with incident CHD and 1980 noncases. Mean follow-up was 11 years. Baseline concentrations of IL-18 were slightly higher in cases than in noncases (172.4 [1.0] versus 161.3 [1.0] pg/mL, respectively; P=0.114), but were clearly elevated for C-reactive protein (CRP) and IL-6 in cases compared with noncases. In multivariable analyses, accounting for classical cardiovascular risk factors and inflammatory markers, no statistically significant association was seen between increased concentrations of IL-18 and incident CHD both in men (hazard ratio [HR] and 95% confidence intervals [CIs] comparing extreme tertiles, 1.20; 95% CI, 0.85 to 1.69), and in women (HR, 1.25; 95% CI, 0.67 to 2.34). However, in this population increased concentrations of CRP and IL-6 were found to be independent predictors of future CHD events, even after multivariable adjustment.


CONCLUSIONS
Elevated concentrations of CRP and IL-6, but not IL-18, were independently associated with risk of CHD in subjects from an area with moderate absolute risk.
Koenig
Wolfgang
W
Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany.
Khuseyinova
Natalie
N
Baumert
Jens
J
Thorand
Barbara
B
Loewel
Hannelore
H
Chambless
Lloyd
L
Meisinger
Christa
C
Schneider
Andrea
A
Martin
Stephan
S
Kolb
Hubert
H
Herder
Christian
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood*; D016757:Death, Sudden, Cardiac; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D020382:Interleukin-18; D015850:Interleukin-6; D002097:C-Reactive Protein