Biomarkers of inflammation predict both vascular and non-vascular mortality in older men.
OBJECTIVE
To compare the predictive value of inflammatory biomarkers and lipids for vascular and non-vascular mortality in older men.


RESULTS
The relevance of inflammatory biomarkers and lipids for vascular and non-vascular mortality was assessed in a prospective study of 5360 men (mean age 77 years) followed for 7 years. Vascular mortality was positively associated with log C-reactive protein (lnCRP), fibrinogen and total/HDL-C (high-density lipoprotein cholesterol), and inversely associated with albumin [age adjusted hazard ratio (HR) per 2-SD higher usual level (approximately the difference between the top and the bottom thirds of the distribution): 2.09 for lnCRP; 1.70 for fibrinogen; 0.50 for albumin and 1.45 for total/HDL-C]. The associations with the inflammatory markers were attenuated after adjustment for established risk factors, including lipids [adjusted HRs: 1.86 (lnCRP); 1.44 (fibrinogen); 0.51 (albumin)], and further attenuated (and, for fibrinogen, no longer predictive) after adjustment for each other [fully adjusted HRs: 1.60 (lnCRP); 1.01 (fibrinogen); 0.61 (albumin)]. Higher CRP and lower albumin levels were also associated with significantly raised non-vascular mortality independently of other characteristics [fully adjusted HRs: 1.62 (lnCRP); 0.65 (albumin)].


CONCLUSIONS
In this cohort of older men, higher CRP and lower albumin levels strongly predicted both vascular and non-vascular mortality, independently of other characteristics.
Clarke
Robert
R
Clinical Trial Service Unit and Epidemiological Studies Unit, Richard Doll Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK. robert.clarke@ctsu.ox.ac.uk
Emberson
Jonathan R
JR
Breeze
Elizabeth
E
Casas
Juan P
JP
Parish
Sarah
S
Hingorani
Aroon D
AD
Fletcher
Astrid
A
Collins
Rory
R
Smeeth
Liam
L
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D017202:Myocardial Ischemia / Q000378:metabolism / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate; D014657:Vasculitis / Q000097:blood / Q000401:mortality*
D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D012709:Serum Albumin; D005340:Fibrinogen; D002097:C-Reactive Protein