Incidence Of Coronary Events Research Articles

Plasma S100A8/A9 Correlates With Blood Neutrophil Counts, Traditional Risk Factors, and Cardiovascular Disease in Middle-Aged Healthy Individuals

The S100 alarmins A8, A9, and A8/A9, secreted by activated neutrophils and monocytes/macrophages, are involved in the pathogenesis of various inflammatory diseases. S100A8/A9 has previously been linked to atherogenesis and cardiovascular (CV) disease. We investigated whether S100A8, A9, and A8/A9 correlate with carotid artery disease and CV risk in apparently healthy individuals. We measured baseline S100A8, A9, and A8/A9 in 664 individuals aged 63 to 68 years, with no previous history of CV disease, randomly selected from the Malmö Diet and Cancer population cohort. We examined the correlations between S100 proteins and circulating cell populations, plasma cytokines, carotid artery disease, and incidence of CV events during a median follow-up period of 16.2 years. We found that plasma S100A8/A9 concentration is positively influenced by circulating neutrophil numbers, smoking, body mass index, glycosylated hemoglobin A1c, and low-density lipoprotein. High-density lipoprotein was negatively associated with S100A8/A9. S100A8/A9 and the neutrophil counts were positively correlated with intima-media area in the common carotid artery, independently of age, sex, and CV risk factors. S100A8/A9 and circulating neutrophils presented similar associations with the incidence of coronary events (hazard ratio [95% confidence interval] per 1 SD: 1.28 [1.03-1.59] and 1.26 [1.04-1.53], respectively) and CV death (1.34 [1.06-1.71] and 1.59 [1.33-1.90], respectively). These relationships were mainly supported by strong associations in women, which were independent of traditional risk factors. There were no independent relationships between S100A8 and S100A9, and CV disease. Our study supports the value of S100A8/A9 as a potentially important link between neutrophils, traditional CV risk factors, and CV disease.

B-type natriuretic peptide: distribution in the general population and the association with major cardiovascular and coronary events—The Heinz Nixdorf Recall Study

A B-type natriuretic peptide (BNP) threshold of 100 pg/ml is used in practice for identification of heart failure, but data about the "normal" distribution of BNP in a large population in primary prevention are rare. We aimed to characterize the BNP distribution in a healthy subset of a population-based cohort and to evaluate the association of elevated BNP levels with major events. In a first step, we determined gender-specific distribution and 90th percentiles of BNP in participants who were at baseline free from known determinants of increased BNP, i.e. cardiovascular disease, hypertension or chronic kidney disease. Consecutively, the association of BNP levels above these 90th percentiles with subsequent cardiovascular and coronary events was assessed in the entire cohort. In the BNP-normal sub-sample (n = 1,639), we defined gender-specific 90th percentile of BNP (31.3 pg/ml for men, 45.5 pg/ml for women). From overall 3,697 subjects (mean age 59.4, 52.4 % female), 194 subjects developed a major cardiovascular event and 122 myocardial infarction during a mean follow-up period of 8.0 ± 1.5 years. The 90th percentiles derived from the normal subset as threshold showed strong associations with major events in the entire cohort even after adjusting for traditional risk factors: hazard ratio (95% CI): 1.86 (1.37; 2.53), p < 0.0001 for cardiovascular, and 1.77 (1.19; 2.62), p = 0.005 for coronary events. The gender-specific 90th percentile of BNP (31 pg/ml for males and 45 pg/ml for females) obtained from a BNP-normal sub-sample is associated with incident major cardiovascular and coronary events, suggesting that even BNP values lower than 100 pg/ml could imply prognostic information in the general population.

LONG TERM RISK OF STROKE VERSUS ACUTE CORONARY EVENTS AFTER TIA AND STROKE: A POPULATION–BASED STUDY

BackgroundSome preventive treatments, such as statins and antihypertensive drug classes, differ in their relative effectiveness in preventing stroke versus coronary events. However, guidelines for secondary prevention of stroke are based...

Change in Positive Affect During Outpatient Cardiac Rehabilitation Predicts Vital Exhaustion in Patients with Coronary Heart Disease

Vital exhaustion is an acknowledged psychosocial risk factor of incident coronary heart disease (CHD) and recurrent CHD events. Little is known about trajectories in vital exhaustion in patients with CHD and the factors predicting this change. We hypothesized that vital exhaustion would decrease during outpatient cardiac rehabilitation and that an increase in positive affect over time would be associated with decreased vital exhaustion at discharge from cardiac rehabilitation. We also explored the role of the patient's sex in this context. Vital exhaustion was reduced during outpatient cardiac rehabilitation, especially in patients who experienced an increase in positive affect over time (p < .001). This relationship was significant in men (p < .001) but not in women (p = .11).

Dialysis-induced segmental wall motion abnormalities, post-dialysis fatigue and cardiovascular mortality: the new Bermuda triangle?

Dialysis patients exhibit higher rates of death compared withthe general population [1], with an almost similar increase inthe proportion of cardiovascular (CV) and non-CV deaths[1]; however, the CV mortality risk in patients starting dialy-sis is much higher compared with the general population(unstandardized CV risk—15-fold higher/age-standardizedCV risk—8.8 higher than in matched individuals from thegeneral population) [1] and is not determined by the samerisk factors. Indeed, classical atherosclerotic disease is not themost important and common cause of death in a moderndialysis population. Sudden cardiac death (SCD) [2] andheart failure are the most frequent forms of death in dialysispatients; the overall incidence of these events is much greaterthan the incidence of coronary events [3]. Moreover, the riskpersists after coronary vascularization [4]. Important factorsfor this significant CV morbidity include left ventricular (LV)hypertrophy, electrolyte shifts during haemodialysis (HD),poor volume control [5] and abnormalities in myocardialultra-structure and function, including endothelial dysfunc-tion, interstitial fibrosis, impaired coronary flow reserve anddiminished ischaemia tolerance.One potential important player in the mechanisms behindthis excess mortality is the HD procedure. It is obvious thatthe HD procedure is stressful for the CV system; almost 30%of HD sessions are associated with significant intra-dialytic hy-potension [6]. Intermittent HD treatments may induce globaland segmental myocardial ischaemia [7, 8]. This was suggestedby Selby’s studies using echocardiography [9, 10] and cardiactroponin levels [11] and by Singh et al.[12] using 99Tc-sesta-mibi single-photon emission computed tomography. Confir-mation that an HD session is undeniably capable of inducingregional myocardial ischaemia was provided recently by McIn-tyre et al. [7]. Using intra-dialytic H215O positron emissiontomography and echocardiography, they showed that HDtreatment elicited reversible (LV) regional wall motion ab-normalities (RWMAs) with matched reductions in myocardialblood flow (MBF). Dasselaar et al.[8] reconfirmed 1 year laterthese results in non-diabetic non-cardiac-compromisedpatients. They observed a significant reduction in MBF, earlyduring dialyses that were not accompanied by significant fluidremoval.In the general population, repeated episodes of transientmyocardial ischaemia lead to a spectrum of disease encom-passing myocardial stunning, myocardial hibernation andending in myocardial remodelling and scarring, with irrevers-ible loss of contractile function. Myocardial stunning isdefined as a prolonged LV dysfunction without histologicalsigns of irreversible injury to cardiomyocytes. It occurs eachtime when ischaemia and reperfusion are present: in patientswith coronary artery disease, after percutaneous transluminalcoronary angioplasty, after coronary bypass or cardiac trans-plantation or following resuscitation. Myocardial stunninghas been well described in the general population as a causa-tive mechanism for heart failure [9]. Myocardial hibernationis described also as depressed myocardial contractility, butthe ischaemic myocardium remains viable and the LV dys-function can be partially or completely restored to normality,by improving/restoring blood flow. In pathophysiologicalterms, a severe reduction in coronary flow reserve is commonfor both conditions, and recovery of function is paralleled byrestoration of an adequate coronary flow reserve.The reduction in MBF during HD is associated with myo-cardial remodelling and eventually non-viable myocardiumwith irreversible reduction in LV function. This processbecomes increasingly appreciated as a principal pathophysio-logic contributor to the excess CV mortality in HD patients

Coronary artery diseases in Japanese patients with nonvalvular atrial fibrillation

BackgroundBoth the prevalence of atrial fibrillation and coronary artery disease (CAD) is increasing in aged societies. However, limited data are available regarding the prevalence of CAD and the incidence of coronary events in Japanese patients with nonvalvular atrial fibrillation (NVAF). Methods and resultsThe data in this study were derived from Shinken Database 2004–2010, which includes 15,227 new patient visitors to the Cardiovascular Institute between June 2004 and March 2011. In the database, 1835 patients were diagnosed with NVAF (mean age 63 years, mean CHADS2 score 1.1±1.1, and 75% were men). The prevalence of CAD at the initial visit was 118 patients (6.4%). They were older age and had a greater prevalence of men, more history of congestive heart failure and more history of cardiovascular risk factors rather than those without. During the follow-up period of 532±599 days, coronary events (myocardial infarction, unstable angina, and stable angina) occurred in 51 patients (1.9%/year). Multivariate analysis showed that a history of CAD (p<0.001) and older age (p=0.024) were independent predictors of the incidence of future coronary events. ConclusionsIn Japanese patients with NVAF, both the presence of CAD and the occurrence of coronary events are not uncommon. History of CAD and older age are strongly associated with the incidence of coronary events.

Associations between long-term exposure to particulate matter constituents and the incidence of coronary events in European cohorts

Background. Long-term effects of air pollution and thereof especially particulate matter (PM) have been associated with increased cardiovascular morbidity and mortality. However, little is known about the influence of chemical PM components. Aim. To assess the effects of residential long-term exposure to PM components on the incidence of coronary events as part of the ESCAPE (European Study of Cohorts for Air Pollution Effects, www.escapeproject.eu) and TRANSPHORM (www.transphorm.eu) projects. Methods. Nine cohorts from Finland, Sweden, Denmark, Germany, and Italy participated in this analysis. 4,798 incident coronary events were identified from 86,852 persons followed on average for eleven years. Long-term residential concentrations of PM&lt;10µm (PM10), PM&lt;2.5µm (PM2.5) and selected constituents (copper, iron, potassium, nickel, sulfur, silica, vanadium, zinc) were estimated with land-use regression models based on a standardized procedure. Cox proportional hazard models adjusted for a common set of confounders were used to estimate cohort-specific component effects with and without including total PM. Random effects meta-analyses were used to pool cohort-specific results. Results. In the nine cohorts, a 5 µg/m³ increase in PM2.5 and a 10 µg/m³ increase in PM10 were associated with a 15% (95%-confidence interval: [-1;34%]) and 11% [-1;24%] increase in coronary events, respectively. PM2.5 and PM10 potassium concentrations were associated with risk increases of 19% [6;34%] and 7% [1;13%] per 50 and 100 ng/m³ increase (cohort-specific IQRs ranging from 0 to 39 and 7 to 144 ng/m³), respectively. When additionally adjusting for total PM, potassium effects slightly strengthened. Other PM constituents showed no significant effect on coronary events. Conclusion. The preliminary results of nine cohorts suggest an association between long-term exposure to PM potassium and incidence of coronary events. The final results of eleven cohorts will be presented at the conference.

Long-Term Exposure to Ambient Air Pollution and Incidence of Coronary Events - Analysis of Eleven European Cohorts from the ESCAPE Project

Long-Term Exposure to Ambient Air Pollution and Incidence of Coronary Events - Analysis of Eleven European Cohorts from the ESCAPE Project

Long-term exposure to air pollutants and cardiovascular disease endpoints in adults

Background. There are only few studies which investigated the association between residential long-term exposure to air pollutants and cardiovascular disease endpoints. Aims. As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) project this work package aimed to quantify the effects of long-term exposures to ambient air pollution on intermediate phenotypes of cardiovascular disease, and on the incidence of coronary artery disease and cerebrovascular disease in differently exposed populations in Europe. Specifically, we evaluated the impact of ambient air pollution on markers of inflammation (aim1), on blood pressure and prevalence of hypertension (aim2), on the risk for build-up of preclinical atherosclerosis measured by intima-media thickness (IMT) of the carotid artery (aim3), and on incident coronary events and stroke (aim4). Methods. All cohorts assessed the spatial variability of residential long-term exposure to particulate matter and nitrogen oxide using land-use regression models. Cohort-specific effect estimates were calculated and subsequently pooled using meta-analysis. Endpoint-specific confounders and effect-modifiers were considered. Results. Seven cohorts contributed to aim1 with 22,561 participants, 12 cohorts to aim2 with 98,448 participants, 4 cohorts to aim3 with 9,331 participants, and 11 cohorts to aim4 with 100,166 participants. Levels of C-reactive protein were associated with traffic exposures and nitrogen oxides. Blood pressure and hypertension were associated with traffic counts. IMT showed associations with traffic in two of the four cohorts, but not on a meta-analytical level. In contrast, the risk of coronary events was related to long-term exposure to inhalable particulate matter. Conclusions.The findings substantiate the link between long-term exposure and ischemic heart disease and indicate that chronic subclinical inflammation may contribute to these associations.

Circulation Research Thematic Synopsis Diabetes and Obesity

<i>Circulation Research</i> Thematic Synopsis Diabetes and Obesity

GW24-e2497 Circulating MicroRNAs as Potential Biomarkers of Coagulation Dysfunction in Patients with Vulnerable Coronary Artery Disease

ObjectivesThe activation of coagulation and fibrinolysis plays a critical role in the incidence of coronary events. MicroRNAs (miRNAs) are small non-coding ribonucleic acids (RNAs) that negatively regulate gene expression on...

Hypertension and stable coronary artery disease

Systemic hypertension is highly prevalent in stable coronary artery disease, a pervasive comorbidity complicating the diagnostic performance and interpretation of non-invasive provocative tests in chest pain patients because of the ischaemic signals generated, despite normal or near normal coronary arteries, by hearts structurally readapted by long-term exposure to raised systemic blood pressure. Additional and unresolved problems posed by arterial hypertension in patients with stable coronary artery disease regard the benefits of antihypertensive treatment due to reports of irrelevant, if not detrimental, effect of blood pressure (BP) lowering in averting coronary relapses as well as the lack of association between BP levels and incident coronary events in survivors from acute myocardial infarction. Uncertainties extend to BP-independent cardioprotective effects of antihypertensive drugs, although the efficacy of renin-angiotensin system blockers in the long-term prevention of cardiovascular events in stable coronary artery disease patients has been shown by several studies, particularly when combined with amlodipine, a dihydropiridine calcium channel blocker. In contrast, the long-term effect of beta-blockers, the antihypertensive class most used in that clinical category, is not supported by strong evidence except that generated in patients with systolic dysfunction and early postmyocardial infarction recovery periods.

Clinical pharmacology of n-3 polyunsaturated fatty acids: non-lipidic metabolic and hemodynamic effects in human patients

A high dietary intake of n-3 long chain polyunsaturated fatty acids (PUFA), eicosapentaenoic and docosahexaenoic acids, is associated with a reduced incidence of coronary events. Supplementation with pharmacological doses of the same may improve survival in patients with previous myocardial infarction and established heart failure. Such protective effects may be explained by the action of n-3 PUFA on systemic inflammation, hypertension, endothelial dysfunction, thrombosis, cardiac arrhythmias, heart rate variability and atherosclerotic plaque instability, which are involved in the pathogenesis of these clinical conditions. In this short paper we will review the evidence in support of these pleiotropic effects of n-3 fatty acids.

EFFECTS OF WORKING ENVIRONMENT ON ISCHEMIC HEART DISEASE BURDEN PROFILE IN YOUNG EGYPTIAN MALES

Introduction: Ischemic Heart Diseases (IHD) are mostly attributed to increased exposure to traditional risk factors. Few studies were directed to understand the environmental and occupational determinants as potentially modifiable risk factors. Aim of work: To evaluate the impact of various working environments on the ischemic heart disease burden profile in young Egyptian male workers. Materials and Methods: Three years follow up of ischemic events in three groups of workers based on the type of industry was performed. Group I (Motor industry) which included 4779 individuals, group II (Construction industry) which included 6230 individuals & group III (Food industry) which included 2613 individuals. Main risk factors analysis were collected from out-patient visits and investigations results, followed by multicenter in time on site monitoring on groups records of in-patient admissions and different interventional coronary procedures performed. Results: Mean age in motor industry group was 34.6 ± 9, in construction group was 35.8 ± 9 while in food industry group was 31.6 ± 7. Total incidence of coronary artery disease in the three groups was 1.5%; of hypertension 4.3 %; of diabetes mellitus 3.5 % and that of dyslipidemia was 2.3 %. Incidence of coronary events in motor industry was significantly higher than the other two industries. Highly significant increase in number of total in-patient and critical care admissions due to acute coronary syndromes and myocardial infarction in addition to number of interventional coronary procedures was observed in motor and construction industries when compared to food industry. Conclusion: Different working environmental hazards might increase the incidence of coronary artery diseases in young Egyptian male workers either directly or through augmenting known risk factors. Morbidity due to IHD might be affected by the type of industry. Cooperation between general practitioners, occupational diseases specialists and cardiologists may improve the efficiency of prevention programs.

Circulation Editors’ Picks

<i>Circulation</i> Editors’ Picks

Coronary heart disease incidence in women by waist circumference within categories of body mass index

High body mass index (BMI) and large waist circumference are separately associated with increased coronary heart disease (CHD) risk but these measures are highly correlated. Their separate associations with incident CHD, cross-classifying one variable by the other, are less investigated in large-scale studies. We examined these associations in a large UK cohort (the Million Women Study), which is a prospective population-based study. We followed 496,225 women (mean age 60 years) with both waist circumference and BMI measurements who had no vascular disease or cancer. Adjusted relative risk and 20-year cumulative CHD incidence (first coronary hospitalization or death) from age 55 to 74 years were calculated using Cox regression. Plasma apolipoproteins were assayed in 6295 randomly selected participants. There were 10,998 incident coronary events after mean follow up of 5.1 years. Within each BMI category (<25, 25-29.9, ≥30 kg/m(2)), CHD risk increased with increasing waist circumference; within each waist circumference category (<70, 70-79.9, ≥79 cm), CHD risk increased with increasing BMI. The cumulative CHD incidence was lowest in women with BMI <25 kg/m(2) and waist circumference <70 cm, with 1 in 14 (95% confidence interval 1 in 12 to 16) women developing CHD in the 20 years from age 55 to 74 years, and highest in women with BMI ≥30 kg/m(2) and waist circumference ≥80 cm, with 1 in 8 (95% confidence interval 1 in 7 to 9) women developing CHD over the same period. Similar associations for apolipoprotein B to A1 ratio across adiposity categories were observed, particularly in non-obese women. Our conclusions were that both waist circumference and BMI are independently associated with incident CHD.

SRAGE and Risk of Diabetes, Cardiovascular Disease, and Death

Advanced glycation end products (AGEs) and their receptors are strongly implicated in the development of diabetes complications. When stimulated by AGEs, the receptors for AGEs (RAGEs) induce inflammation and are thought to fuel disease progression. Soluble circulating RAGE (sRAGE) may counteract the detrimental effects of RAGE. We measured sRAGE in stored plasma from a random sample of 1,201 participants in the Atherosclerosis Risk in Communities (ARIC) Study who were aged 47–68 years, had normal kidney function, and had no history of cardiovascular disease. In cross-sectional analyses, black race, male sex, higher BMI, and higher C-reactive protein were independently associated with low sRAGE. The racial difference was striking, with blacks approximately three times more likely to have low sRAGE compared with whites even after adjustment. During ~18 years of follow-up, there were 192 incident coronary heart disease events, 53 ischemic strokes, 213 deaths, and 253 cases of diabetes (among the 1,057 persons without diabetes at baseline). In multivariable Cox models comparing risk in the first quartile with that in the fourth quartile of baseline sRAGE, low levels of sRAGE were significantly associated with risk of diabetes (hazard ratio 1.64 [95% CI 1.10–2.44]), coronary heart disease (1.82 [1.17–2.84]), and mortality (1.72 [1.11–2.64]) but not ischemic stroke (0.78 [0.34–1.79]). In conclusion, we found that low levels of sRAGE were a marker of future chronic disease risk and mortality in the community and may represent an inflammatory state. Racial differences in sRAGE deserve further examination.

Predicting risk of coronary events and all-cause mortality: role of B-type natriuretic peptide above traditional risk factors and coronary artery calcium scoring in the general population: the Heinz Nixdorf Recall Study

Several biomarkers including B-type natriuretic peptide (BNP) have been suggested to improve prediction of coronary events and all-cause mortality. Moreover, coronary artery calcium (CAC) as marker of subclinical atherosclerosis is a strong predictor for cardiovascular mortality and morbidity. We aimed to evaluate the predictive ability of BNP and CAC for all-cause mortality and coronary events above traditional cardiovascular risk factors (TRF) in the general population. We followed 3782 participants of the population-based Heinz Nixdorf Recall cohort study without coronary artery disease at baseline for 7.3 ± 1.3 years. Associations of BNP and CAC with incident coronary events and all-cause mortality were assessed using Cox regression, Harrell's c, and time-dependent integrated discrimination improvement (IDI(t), increase in explained variance). Subjects with high BNP levels had increased frequency of coronary events and death (coronary events/mortality: 14.1/28.2% for BNP ≥100 pg/ml vs. 2.7/5.5% for BNP < 100 pg/ml, respectively). Subjects with a BNP ≥100 pg/ml had increased incidence of hard endpoints sustaining adjustment for CAC and TRF (for coronary events: hazard ratio (HR) (95% confidence interval (CI)) 3.41(1.78-6.53); for all-cause mortality: HR 3.35(2.15-5.23)). Adding BNP to TRF and CAC increased measures of predictive ability: coronary events (Harrell's c, for coronary events, 0.775-0.784, p = 0.09; for all-cause mortality 0.733-0.740, p = 0.04; and IDI(t) (95% CI), for coronary events: 2.79% (0.33-5.65%) and for all-cause mortality 1.78% (0.73-3.10%). Elevated levels of BNP are associated with excess incident coronary events and all-cause mortality rates, with BNP and CAC significantly and complementary improving prediction of risk in the general population above TRF.

Effect of hormone replacement therapy on cardiovascular outcomes: a meta-analysis of randomized controlled trials.

BackgroundHormone replacement therapy (HRT) is widely used to controlling menopausal symptoms and prevent adverse cardiovascular events. However, the benefit and risk of HRT on cardiovascular outcomes remains controversial.Methodology and Principal FindingsWe systematically searched the PubMed, EmBase, and Cochrane Central Register of Controlled Trials databases for obtaining relevant literature. All eligible trials reported on the effects of HRT on cardiovascular outcomes. We did a random effects meta-analysis to obtain summary effect estimates for the clinical outcomes with use of relative risks calculated from the raw data of included trials. Of 1903 identified studies, we included 10 trials reporting data on 38908 postmenopausal women. Overall, we noted that estrogen combined with medroxyprogesterone acetate therapy as compared to placebo had no effect on coronary events (RR, 1.07; 95%CI: 0.91–1.26; P = 0.41), myocardial infarction (RR, 1.09; 95%CI: 0.85–1.41; P = 0.48), stroke (RR, 1.21; 95%CI: 1.00–1.46; P = 0.06), cardiac death (RR, 1.19; 95%CI: 0.91–1.56; P = 0.21), total death (RR, 1.06; 95%CI: 0.81–1.39; P = 0.66), and revascularization (RR, 0.95; 95%CI: 0.83–1.08; P = 0.43). In addition, estrogen therapy alone had no effect on coronary events (RR, 0.93; 95%CI: 0.80–1.08; P = 0.33), myocardial infarction (RR, 0.95; 95%CI: 0.78–1.15; P = 0.57), cardiac death (RR, 0.86; 95%CI: 0.65–1.13; P = 0.27), total mortality (RR, 1.02; 95%CI: 0.89–1.18; P = 0.73), and revascularization (RR, 0.77; 95%CI: 0.45–1.31; P = 0.34), but associated with a 27% increased risk for incident stroke (RR, 1.27; 95%CI: 1.06–1.53; P = 0.01).Conclusion/SignificanceHormone replacement therapy does not effect on the incidence of coronary events, myocardial infarction, cardiac death, total mortality or revascularization. However, it might contributed an important role on the risk of incident stroke.

Abstract 318: Circulating Neutrophils and their Secreted Mediator S100A8/A9 Correlate with Carotid Artery Disease and Predict Cardiovascular Events in Healthy Individuals

Aims S100A8/A9 is an inflammatory mediator secreted by activated neutrophils and monocytes/macrophages. Serum S100A8/A9 levels were previously found to correlate with the severity of coronary artery disease in diabetic patients and to predict cardiovascular (CV) events in healthy postmenopausal women. Our aim was to investigate whether S100A8/A9 correlates with carotid artery disease and whether it can predict CV risk in healthy individuals. Methods We measured baseline levels of S100A8/A9 in 664 individuals with no previous history of CV disease, randomly selected from the Malmö Diet and Cancer cohort. We examined the correlation between S100A8/A9 and traditional CV risk factors, circulating cell populations, plasma cytokines, carotid intima media thickness (IMT) and area (IM area), and the incidence of CV events during a follow-up period of 16.2 years. Results We detected significant positive correlations between baseline S100A8/A9 and the number of circulating neutrophils, IFNγ, TNFα, IL-1β, smoking, BMI, systolic blood pressure and an inverse correlation with HDL. In a multivariate linear regression model adjusted for age and sex, S100A8/A9 and the neutrophil counts were correlated with IMT and IM area in the common carotid artery. The associations with IM area remained significant after further adjustment for CV risk factors. In a Cox regression model corrected for age and sex, S100A8/A9 and circulating neutrophils predicted the incidence of coronary events (fatal or non-fatal myocardial infarction) [HR (95%CI) per SD: 1.28 (1.03-1.59), P =0.026 and 1.26 (1.04-1.53), P =0.020, respectively] and CV death [1.34 (1.06-1.71), P =0.015 and 1.59 (1.33-1.90), P &lt;0.001, respectively]. There was no relationship with stroke. Conclusions S100A8/A9 correlates strongly with circulating neutrophil numbers, but not with monocytes or monocyte sub-populations. Baseline S100A8/A9 concentrations and circulating neutrophils are significantly associated with carotid artery disease and predict coronary events and CV death in apparently healthy individuals. Our study provides further evidence for the involvement of activated neutrophils in atherogenesis and acute coronary events.