C-reactive protein, interleukin-6 and tumor necrosis factor alpha as predictors of incident coronary and cardiovascular events and total mortality A population-based, prospective study
Karolina Tuomisto, Pekka Jousilahti, Jouko Sundvall, Pia Pajunen, Veikko Salomaa
KTL – National Public Health Institute, Helsinki, Finland
Summary Previous studies have shown an association between serumC-reactive protein (CRP) and cardiovascular disease (CVD)risk.The roles of interleukin-6 (IL-6) and tumor necrosis factoralpha (TNFa ) are less well established.The aim of the presentstudy was to analyze the associations of CRP, IL-6 and TNFawith incident coronary heart disease (CHD) events, CVDevents, and total mortality. A random population sample, includingmen and women aged 25–64 years was examined in Finlandin 1992.The sample size was 7,927 and 6,051 (76%) participated.The cohort was followed up until the end of 2001. During thefollow-up, 151 incident CHD events, 205 CVD events and 183deaths from any cause were observed.A stratified random subsample(n=313) was used as the comparison group.After adjustmentfor conventional CVD risk factors, CRP showed a significant association with CHD risk in men (HR=2.39, 1.08–5.28,comparing fourth quartile to the first quartile).This associationremained significant after further adjustment for TNFa . TNFaalso was a significant predictor of CHD among men, but the associationwas nonlinear (HR=2.21, 1.18–4.14 comparing thethree upper quartiles to the first quartile). Further adjustmentfor CRP did not change this association substantially. Both CRPand TNFa predicted also all CVD events and total mortalityamong men.Among women the findings were nonsignificant. Inconclusion,CRP andTNFa were significant,independent predictorsof CHD and CVD events and total mortality among men.These findings provide further support to the important role ofinflammation in the pathogenesis of CVD.
Cardiovascular Disease, inflammation, cytokines, myocardial infarction