Association of inflammatory markers and carotid intima-media thickness with the risk of cardiovascular events in high-risk patients.
OBJECTIVE
Both inflammatory markers and carotid intima-media thickness (IMT) are associated with future cardiovascular disease (CVD). We investigated whether inflammatory markers can be predictors for incident CVD independent of carotid IMT in atherosclerotic high-risk patients and evaluated the joint effect of inflammatory markers and IMT in CVD prediction.


METHODS
We performed a prospective cohort study of 770 patients who had one or more atherosclerotic risk factors. Serum high-sensitive C-reactive protein (hsCRP), interleukin (IL)-6, IL-18, and carotid IMT were assessed at baseline and the incidence of CVD was determined.


RESULTS
During 4.3 years of mean follow-up, CVD occurred in 104 patients (14%). In univariate analyses, higher levels of hsCRP, IL-6, and IL-18 were significantly related to an increased risk of CVD. However, only IL-6, but not hsCRP or IL-18, was associated with incident CVD after adjustment for conventional risk factors and carotid IMT (hazard ratio of upper half to lower half, 1.87; 95% confidence interval, 1.20-2.93). Measuring IL-6 level in combination with carotid IMT improves the prediction of incident CVD.


CONCLUSIONS
Elevated IL-6 is associated with the risk of CVD independently of carotid IMT in atherosclerotic high-risk patients.
Okazaki
Shuhei
S
Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan. s-okazaki@umin.ac.jp
Furukado
Shigetaka
S
Abe
Yuko
Y
Tanaka
Makiko
M
Miwa
Kaori
K
Yamagami
Hiroshi
H
Sakaguchi
Manabu
M
Sakoda
Saburo
S
Kitagawa
Kazuo
K
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000276:immunology / Q000401:mortality / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000150:complications / Q000276:immunology* / Q000401:mortality; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D015854:Up-Regulation
D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D002097:C-Reactive Protein