Inflammatory Markers and the Risk of Coronary Heart Disease in Men and Women

• Published in: The New England journal of medicine Vol. 351; no. 25; pp. 2599 - 2610
• Main Authors: Pai, Jennifer K, Pischon, Tobias, Ma, Jing, Manson, JoAnn E, Hankinson, Susan E, Joshipura, Kaumudi, Curhan, Gary C, Rifai, Nader, Cannuscio, Carolyn C, Stampfer, Meir J, Rimm, Eric B
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 16.12.2004
• Subjects: Adult; Aged; Biological and medical sciences; C-Reactive Protein - analysis; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - immunology; Case-Control Studies; Coronary heart disease; Cytokines; Female; Follow-Up Studies; General aspects; Heart; Heart attacks; Humans; Interleukin-6 - blood; Logistic Models; Male; Medical sciences; Mens health; Middle Aged; Multivariate Analysis; Proteins; Questionnaires; Receptors, Tumor Necrosis Factor, Type I - blood; Receptors, Tumor Necrosis Factor, Type II - blood; Risk; Sex Factors; Womens health; United States > US; Medicine; Risk factor; Sex; Biological marker; Cardiovascular disease; Biological indicator; Risk; Inflammation; Coronary heart disease
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa040967

This study examined the relation between the level of C-reactive protein (CRP) and other inflammatory markers and the risk of coronary heart disease in large cohorts of men and women who were free of cardiovascular disease at baseline. During a follow-up period of six to eight years, men and women with CRP levels of at least 3 mg per liter had a risk of coronary events that was 1.68 times that of those with CRP levels of less than 1 mg per liter. Although lipid levels were better predictors of coronary risk, C-reactive protein was a significant predictor of risk in both sexes. Inflammation plays an essential role in the development of insulin resistance and type 2 diabetes mellitus, the initiation and progression of atherosclerotic lesions, and plaque disruption. 1 , 2 Interleukin-6 and tumor necrosis factor α (TNF-α) are inflammatory cytokines and the main inducers of the secretion of C-reactive protein in the liver. 3 C-reactive protein is a marker of low-grade inflammation, and recent studies suggest that this protein has a role in the pathogenesis of atherosclerotic lesions in humans. 4 The effects of TNF-α are mediated by two receptors, type 1 and type 2 (TNF-R1 and TNF-R2), which circulate in soluble forms (sTNF-R1 and . . .