C-reactive protein, interleukin 6, fibrinogen and risk of sudden death in European middle-aged men: the PRIME study.
OBJECTIVE
To examine prospectively the association of high-sensitivity C-reactive protein, interleukin 6, and fibrinogen with sudden death in asymptomatic European men.


RESULTS
Among the 9771 men from the Etude PRospective de l'Infarctus du Myocarde (PRIME) Study, 664 had a first coronary heart disease over 10 years, including 50 sudden deaths, 34 nonsudden coronary deaths, and 580 nonfatal coronary heart disease events. For each outcome, 2 matched controls, who were free of coronary heart disease at the index date, were randomly selected from the initial cohort (nested case control study design). There was a 3-fold increased risk (95% CI, 1.20 to 7.81) of sudden death between the upper and the lower third of interleukin 6 after adjustment for baseline confounders in conditional logistic regression analysis. Neither high-sensitivity C-reactive protein (hazard ratio(third versus first tertile)=1.27; 95% CI, 0.51 to 3.17) nor fibrinogen (hazard ratio(third versus first tertile)=1.90; 95% CI, 0.76 to 4.75) was associated with sudden death. For comparison, there was a 6-fold increased risk of nonsudden coronary death from the highest compared with the lowest tertile of fibrinogen and a trend toward an association with higher C-reactive protein and higher interleukin 6. All 3 inflammatory biomarkers were moderately, but significantly, associated with nonfatal coronary heart disease.


CONCLUSIONS
Interleukin 6, but not high-sensitivity C-reactive protein or fibrinogen, is an independent predictor of sudden death in asymptomatic European men.
Empana
Jean-Philippe
JP
Institut National de la Santé et de la Recherche Médicale, Unité 970, Paris Cardiovascular Research Center; Université Paris Descartes, Unité Mixte de Recherche en Santé 970, Paris, France . jean-philippe.empana@inserm.fr
Jouven
Xavier
X
Canouï-Poitrine
Florence
F
Luc
Gerald
G
Tafflet
Muriel
M
Haas
Bernadette
B
Arveiler
Dominique
D
Ferrieres
Jean
J
Ruidavets
Jean-Bernard
JB
Montaye
Michèle
M
Yarnell
John
J
Morange
Pierre
P
Kee
Frank
F
Evans
Alun
A
Amouyel
Philippe
P
Ducimetiere
Pierre
P
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000209:etiology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005060:Europe; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D005340:Fibrinogen; D002097:C-Reactive Protein