Abstract 17882: GlycA, a Novel Inflammatory Marker, Is Strongly Associated With Mortality in Both Women and Men
Introduction: GlycA is a novel inflammatory marker highly associated with cardiovascular (CV) morbidity and mortality. Hs-CRP is known to have a strong association with mortality in men, but not women; whether the association between GlycA with mortality differs by sex is not known.
Methods: GlycA was measured using NMR spectroscopy in the CATHGEN biorepository linked to mortality data (n=8,436). The proportional hazards assumption was violated in cox hazards modeling; thus flexible parametric modeling was used. Interaction between sex and GlycA in full model adjusted for age, race, history of DM, HTN, obesity, smoking, and prior MI was significant (p <0.001); therefore analyses were stratified by sex. Association of hs-CRP with mortality was evaluated (n=1,648) and sensitivity analyses were performed with participants with lipid data (n=1,979).
Results: Over a mean of 6.6 years, 28.2% women and 30.9% men died. Women had greater median GlycA plasma concentrations at baseline (387.4 vs. 357.3 μmol/L; women vs. men). Compared to the lowest quartile of GlycA, those in the highest quartile of GlycA had a strong association with mortality in both sexes; hazard ratio 2.24 (p<0.001) in men and 2.13 (p<0.001) in women. Total cholesterol, LDL-C, and HDL-C were not significantly associated with mortality. Women had greater median hs-CRP concentrations (5.41 vs. 3.34 mg/L; women vs. men). Sex and hs-CRP interaction was significant (p<0.001); thus analyses were stratified by sex. Men had a dose-response increase in association with mortality within increasing quartiles of hs-CRP (HR 3.10, p<0.001 in highest quartile); only women with hs-CRP in the highest quartile had significant association with mortality (HR 1.75, p=0.002).
Conclusions: GlycA has a strong, graded association with mortality by increasing quartile of GlycA in both men and women; this is in contrast to hs-CRP. More research is needed as to whether GlycA may be a more reliable measure of inflammation in women.
- Sex differences
- Inflammation and inflammatory markers
- Cardiovascular disease prevention
Author Disclosures: B. Doran: None. C. Haynes: None. R. McGarrah: None. W.E. Kraus: Research Grant; Modest; Liposcience Inc.. D. Craig: None. S.H. Shah: None.
- © 2016 by American Heart Association, Inc.