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Clin Chem. 2017 Mar;63(3):663-672. doi: 10.1373/clinchem.2016.260828. Epub 2016 Dec 28.

Peripheral Inflammatory Biomarkers for Myocardial Infarction Risk: A Prospective Community-Based Study.

Author information

1
Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
2
Department of Cardiology, Kailuan Hospital, Tangshan, People's Republic of China.
3
Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
4
Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA.
5
Department of Nutritional Sciences, Pennsylvania State University, State College, PA.
6
Department of Cardiology, Kailuan Hospital, Tangshan, People's Republic of China; xxg14@psu.edu drwusl@163.com.
7
Department of Nutritional Sciences, Pennsylvania State University, State College, PA. xxg14@psu.edu drwusl@163.com.

Abstract

BACKGROUND:

Most previous studies regarding chronic inflammation and risk of myocardial infarction (MI) have lacked repeated measures of high-sensitivity C-reactive protein (hs-CRP) and/or white blood cell (WBC) count over time. We examined whether cumulative average and longitudinal changes in these biomarkers were associated with subsequent MI risk.

METHODS:

In this prospective, community-based study, we included 82544 Chinese participants [66796 men and 15748 women; mean (SD) age 55.1 (9.86) y] without prior cardiovascular diseases or cancer at baseline (2006-2007). hs-CRP, WBC and other clinical covariates were assessed at baseline and every 2 years during follow-up.

RESULTS:

During 6 years of follow-up (2006-2012), we documented 714 incident MI cases. Higher baseline and cumulative average concentrations of hs-CRP and/or WBC were consistently associated with increased risk of MI (Ptrend <0.001 for both). Longitudinal increase in hs-CRP (Ptrend <0.001), but not WBC, was also associated with a higher future risk of MI, after adjustment for their baseline values and other covariates. Each 1-mg/L increment per year in hs-CRP was associated with a 9.3% increase in risk for future MI [hazard ratio (HR) = 1.09, 95% CI, 1.03; 1.17]. Participants with high-grade inflammatory status (hs-CRP ≥10 mg/L and WBC ≥10 × 109/L) had a higher risk of MI occurring <3 months after hs-CRP/WBC assessments vs those with hs-CRP <0.5 mg/L and WBC <5 × 109/L (HR = 6.64; 95% CI, 1.49-29.6), as compared with MI occurring ≥4 years (HR = 2.95; 95% CI, 0.90, 9.65).

CONCLUSIONS:

Plasma hs-CRP concentration and WBC predicted MI risk. Longitudinal increase in hs-CRP was also associated with a higher risk of MI.

PMID:
28031418
DOI:
10.1373/clinchem.2016.260828
[Indexed for MEDLINE]
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