Inflammation-sensitive plasma proteins are associated with increased incidence of heart failure: a population-based cohort study.
BACKGROUND
Although inflammation has been associated with different cardiovascular diseases, the relationships with future heart failure (HF) are unclear. This population-based study explored whether elevated plasma levels of inflammatory proteins are associated with incidence of HF.


METHODS
Five inflammation-sensitive plasma proteins (ISPs, fibrinogen, ceruloplasmin, haptoglobin, orosomucoid, and alpha1-antitrypsin) was measured in 6071 men (mean age 46 years) without history of myocardial infarction (MI) or stroke. Incidence of hospitalizations due to HF (primary diagnosis) was monitored over 22 years of follow-up, in relation to the number of elevated ISPs (i.e., in the 4th quartile). Subjects with myocardial infarction during follow-up were censored.


RESULTS
During the follow-up, 159 men were hospitalized due to HF. Baseline levels of all ISPs, except for haptoglobin, were significantly higher in men who developed HF. After adjustments for confounding factors, the hazard ratios (HR) of HF were 1.00 (reference), 1.7 (95% CI: 1.1-2.7), 2.0 (CI: 1.2-3.3) and 2.6 (CI: 1.6-4.1), respectively, in men with none, one, two and three or more ISPs in the 4th quartile (trend: p<0.001). Of the individual ISPs, fibrinogen, ceruloplasmin and alpha1-antitrypsin showed significant relationships with incidence of HF after adjustment for risk factors.


CONCLUSIONS
Plasma levels of inflammatory markers are associated with long-term incidence of hospitalizations due to HF in middle-aged men.
Engström
Gunnar
G
Department of Clinical Sciences, Lund University, Malmö University Hospital, Sweden. gunnar.engstrom@med.lu.se
Hedblad
Bo
B
Tydén
Patrik
P
Lindgärde
Folke
F
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001798:Blood Proteins / Q000276:immunology / Q000378:metabolism; D015331:Cohort Studies; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology / Q000276:immunology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors
D015415:Biomarkers; D001798:Blood Proteins