Abstract 14731: Association of Longitudinal Changes in CRP, IL-6, and Fibrinogen Level With Cardiovascular Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA)
Background: Inflammatory biomarkers have been used for cardiovascular disease (CVD) risk stratification. However, the relevance of longitudinal changes in levels of these biomarkers in relation to CVD is unclear.
Methods: MESA is a population-based cohort consisting of 6814 participants free of symptomatic cardiovascular disease at baseline. We included all participants who had blood assayed for measurement of inflammatory biomarkers - C-reactive protein (CRP), Interleukin-6 (IL-6), and fibrinogen measured at baseline and follow-up 2-4 years later (n=1,362). Coronary heart disease (CHD) was assessed as any of myocardial infarction, resuscitated cardiac arrest, definite angina, probable angina (if followed by revascularization) and CHD death. CVD was considered a composite of CHD, stroke, stroke death, atherosclerotic death and CVD death. Cox proportional hazard regression analysis was used to assess the association of annual longitudinal changes in inflammatory biomarker level and time to first CHD and CVD event after adjustment for traditional risk factors and demographics.
Results: The mean (SD) age was 61.6 (9.8) years and 55% were male. Over 8.6 median (IQR, 8.4-9.3) years of follow-up, there were 87 CHD and 121 CVD events. The median (IQR) CRP (mg/L), IL-6 (pg/ml) and fibrinogen (mg/dl) levels at baseline were 1.74(0.82-3.95) 1.11(0.71-1.72) and 332(292-382); and at follow-up were 1.4(0.69-3.03), 1.76(1.16-2.72) and 421(371-476). An increase in IL6 of 1 pg/mL/year was associated with a 26% increased risk of total CVD events independent of risk factors, while an increase of 1 mg/L/year of CRP was independently associated with a 7% and 6% increased risk of both CHD and CVD events respectively. There were no significant associations with changes in fibrinogen.
Conclusion: Longitudinal increases in the inflammatory biomarkers CRP and IL6 are associated with higher risk of future cardiovascular events in a multi-ethnic population.
Author Disclosures: H. Bakhshi: None. M.R. Ostovaneh: None. B. Ambale Venkatesh: None. M. Allison: None. D. Herrington: None. M. Cushman: Honoraria; Modest; Diadexus. Research Grant; Significant; Diadexus. M. Szklo: None. C.O. Wu: None. M. Blaha: None. M. Budoff: Research Grant; Significant; Grant support from NIH and General Electric. R. Tracy: None. D.A. Bluemke: None. J.A. Lima: None.
- © 2015 by American Heart Association, Inc.