Comparison of interleukin-6 and high-sensitivity C-reactive protein for cardiovascular risk assessment: Findings from the MESA study

Data de publicação: 01/01/2024 Data Ahead of Print: 24/01/2024

Autores da FMUP

• João Pedro Melo Marques Pinho Ferreira

  Autor

• Joaquim Adelino Correia Ferreira Leite Moreira

  Autor

Participantes de fora da FMUP

• Vasques-Nóvoa F.
• Neves J.S.
• Zannad F.

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background and aims: Inflammation is a risk factor for major adverse cardiovascular events (MACE). Elevated levels of both high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL6) have been associated with MACE. However, few studies have compared IL6 to hsCRP for cardiovascular risk assessment. Using the MESA (Multi-Ethnic Study of Atherosclerosis) study cohort, we aim to compare IL6 to hsCRP. Methods: We divided IL6 and hsCRP by their median values and created 4 groups i.e., low-low, high-low, low-high and high-high. The median follow-up was 14 years. Results: 6614 (97 %) participants had complete baseline IL6 and hsCRP data. The correlation between hsCRP and IL6 was modest (Rho = 0.53). IL6 =1.2 pg/mL (median) was present in 3309 participants, and hsCRP =1.9 mg/L (median) was present in 3339 participants. Compared to participants with low IL6 and low hsCRP, those with high IL6 and high hsCRP were older (64 vs. 60 years), more frequently women (63 % vs. 45 %), and with more cardiovascular co-morbidities. hsCRP outcome associations lost statistical significance when adjusting for IL6: MACE HR (95 %CI) 1.06 (0.93–1.20), p =0.39, whereas IL6 associations remained significant after adjusting for hsCRP: HR (95 %CI) 1.44 (1.25–1.64), p <0.001. The C-index of Framingham score for did not improve with hsCRP but improved with IL6. Compared to participants with low IL6 and low hsCRP, those with high IL6, regardless of hsCRP, experienced an increased risk of MACE, heart failure and mortality. Conclusions: In a diverse and asymptomatic population, IL6 showed a stronger association with atherosclerotic, heart failure and fatal outcomes than hsCRP. © 2024 Elsevier B.V.

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Keywords

• Atherosclerosis; C-Reactive Protein; Cardiovascular Diseases; Disease Progression; Female; Heart Disease Risk Factors; Heart Failure; Humans; Interleukin-6; Risk Assessment; Risk Factors; C reactive protein; interleukin 6; C reactive protein; interleukin 6; adult; aged; Article; cardiovascular disease; cardiovascular risk; cohort analysis; comorbidity; controlled study; fatality; female; follow up; Framingham risk score; heart failure; human; inflammation; major clinical study; male; mortality; risk assessment; risk factor; special situation for pharmacovigilance; atherosclerosis; cardiovascular disease; complication; disease exacerbation; heart disease risk factor; heart failure; risk assessment