Abstract 3654: Inflammation Factors, Coronary Calcium and Risk of Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Background . Inflammation factors and coronary calcium score are associated with risk of CVD events. There are few studies including large numbers of participants from minority ethnic groups. Methods. From 2000 –2002, 6,814 men and women without CVD were enrolled; white, black, Hispanic and Chinese; aged 45– 84, free of CVD. We measured C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen and computed tomography for coronary artery calcium (CAC) scoring. Over 3.5 years follow up there were 238 first CVD events in 227 participants (64 myocardial infarction, 85 angina, 8 cardiac arrest, 58 stroke, 23 CVD death). Proportional hazards models were used to calculate HRs of overall CVD, adjusted for age, sex, ethnicity, standard risk factors and statin use. Results. Age and sex-adjusted HRs (95% CI) of CVD for CRP >3 mg/L (vs <1 mg/L) and IL-6 or fibrinogen in the 3 rd vs 1 st tertile were 1.71 (1.21–2.42), 1.61 (1.13–2.32) and 1.59 (1.28 –2.28), respectively. Fully adjusted HRs were 1.41 (0.98 –2.04), 1.30 (0.89 –1.91) and 1.17 (0.80 –1.70). Exclusion of angina as an endpoint increased the adjusted HR for CRP (1.63; 1.01–2.63) but not IL-6 or fibrinogen. There were no significant differences of these associations by sex or ethnicity. Within categories of baseline CAC, associations of CRP and IL-6 with CVD events were only present among those with CAC 1–100 Agatston units (table ). Discussion. Associations of inflammation factors with future CVD in this study were weaker than in other studies of primarily white participants. Stronger associations among those with low levels of detectable CAC suggest detection of plaque vulnerability with biomarkers in these individuals with modest atherosclerotic burden. Adjusted HR of CVD for Baseline Inflammation Markers by CAC Category (Agatston Units)