Biomarkers of inflammation predict both vascular and non-vascular mortality in older men


Clarke, R; Emberson, JR; Breeze, E; Casas, JP; Parish, S; Hingorani, AD; Fletcher, A; Collins, R; Smeeth, L; (2008) Biomarkers of inflammation predict both vascular and non-vascular mortality in older men. European heart journal, 29 (6). pp. 800-809. ISSN 0195-668X DOI: https://doi.org/10.1093/eurheartj/ehn049

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Abstract

Aims To compare the predictive value of inflammatory biomarkers and lipids for vascular and non-vascular mortality in older men. Methods and results The relevance of inflammatory biomarkers and lipids for vascular and non-vascular mortality was assessed in a prospective study of 5360 men (mean age 77 years) followed for 7 years. Vascular mortality was positively associated with log C-reactive protein (lnCRP), fibrinogen and total/HDL-C (high-density lipoprotein cholesterol), and inversely associated with albumin [age adjusted hazard ratio (HR) per 2-SD higher usual level (approximately the difference between the top and the bottom thirds of the distribution): 2.09 for lnCRP; 1.70 for fibrinogen; 0.50 for albumin and 1.45 for total/HDL-C]. The associations with the inflammatory markers were attenuated after adjustment for established risk factors, including lipids [adjusted HRs: 1.86 (lnCRP); 1.44 (fibrinogen); 0.51 (albumin)], and further attenuated (and, for fibrinogen, no longer predictive) after adjustment for each other [fully adjusted HRs: 1.60 (lnCRP); 1.01 (fibrinogen); 0.61 (albumin)]. Higher CRP and lower albumin levels were also associated with significantly raised non-vascular mortality independently of other characteristics [fully adjusted HRs: 1.62 (lnCRP); 0.65 (albumin)]. Conclusion In this cohort of older men, higher CRP and lower albumin levels strongly predicted both vascular and non-vascular mortality, independently of other characteristics.

Item Type: Article
Keywords: C-reactive protein, lipids, prediction of mortality in old age, C-REACTIVE PROTEIN, CORONARY-HEART-DISEASE, DENSITY-LIPOPROTEIN, CHOLESTEROL, APPARENTLY HEALTHY-MEN, LONDON CIVIL-SERVANTS, MIDDLE-AGED, MEN, CARDIOVASCULAR-DISEASE, RISK-FACTORS, FOLLOW-UP, ARTERY-DISEASE
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 18303034
Web of Science ID: 254293500019
URI: http://researchonline.lshtm.ac.uk/id/eprint/7570

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