Association of inflammatory markers and carotid intima-media thickness with the risk of cardiovascular events in high-risk patients

Cerebrovasc Dis. 2010;30(2):180-7. doi: 10.1159/000317106. Epub 2010 Jun 29.

Abstract

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.

MeSH terms

  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / immunology
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / pathology
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology*
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / mortality
  • Carotid Artery Diseases / pathology*
  • Chi-Square Distribution
  • Disease-Free Survival
  • Female
  • Humans
  • Incidence
  • Inflammation / complications
  • Inflammation / immunology*
  • Inflammation / mortality
  • Inflammation Mediators / blood*
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Japan
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology*
  • Tunica Media / diagnostic imaging
  • Tunica Media / pathology*
  • Ultrasonography
  • Up-Regulation

Substances

  • Biomarkers
  • CXCL8 protein, human
  • IL6 protein, human
  • Inflammation Mediators
  • Interleukin-6
  • Interleukin-8
  • C-Reactive Protein