Inflammation biomarkers and near-term death in older men.
Associations of C-reactive protein (CRP) and fibrinogen with death may weaken over time. Combining both markers may improve prediction of death in older adults. In 5,828 Cardiovascular Health Study participants (United States, 1989-2000), 383 deaths (183 cardiovascular disease (CVD)) in years 1-3 (early) and 914 deaths (396 CVD) in years 4-8 (late) occurred. For men, when comparing highest to lowest quartiles, hazard ratios for early death were 4.1 (95% confidence interval (CI): 2.7, 6.3) for CRP and 4.1 (95% CI: 2.7, 6.4) for fibrinogen in models adjusted for CVD risk. For early CVD death, hazard ratios were 4.3 (95% CI: 2.2, 8.4) and 3.4 (95% CI: 1.8, 6.3), respectively. When comparing men in the highest quartiles of both biomarkers with those in the lowest, hazard ratios were 9.6 (95% CI: 4.3, 21.1) for early death and 13.5 (95% CI: 3.2, 56.5) for early CVD death. Associations were weaker for late deaths. For women, CRP (hazard ratio = 2.3, 95% CI: 1.4, 3.9), but not fibrinogen (hazard ratio = 1.3, 95% CI: 0.8, 2.2), was associated with early death. Results were similar for CVD death. Neither was associated with late deaths. CRP and fibrinogen were more strongly associated with death in older men than women and more strongly associated with early than late death. Combining both markers may identify older men at greatest risk of near-term death.
Jenny
Nancy Swords
NS
Department of Pathology, College of Medicine, University of Vermont, Colchester Research Facility, 208 South Park Drive, Colchester, VT 05446, USA. Nancy.Jenny@uvm.edu
Yanez
N David
ND
Psaty
Bruce M
BM
Kuller
Lewis H
LH
Hirsch
Calvin H
CH
Tracy
Russell P
RP
D017677:Age Distribution; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D048909:Diabetes Complications / Q000150:complications; D016021:Epidemiologic Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein