AIMS
The relative contributions of inflammatory and atherogenic lipoprotein pathways to residual cardiovascular risk remain unclear. We examined the joint and independent associations of interleukin-6 (IL-6) and apolipoprotein B (ApoB) with major adverse cardiovascular events (MACE) and mortality.
METHODS
Among 34,064 UK Biobank participants free of prevalent atherosclerotic cardiovascular disease with Olink proteomics, multivariable Cox models estimated hazard ratios (HRs) for MACE (myocardial infarction (MI), stroke, or cardiovascular death), MACE components, and all-cause mortality. Models adjusted for demographics, HDL cholesterol, triglycerides, lipid-lowering therapy, hypertension, diabetes, smoking, eGFR, BMI, and high sensitivity C-reactive protein. Participants were additionally classified into four groups by median IL-6 and an ApoB threshold of 90 mg/dL.
RESULTS
Over a median 13.6 years, 2551 (7.5%) MACE events occurred. In continuous models, IL-6 and ApoB were each independently associated with MACE (IL-6 HR 1.11 per SD, 95% CI 1.07-1.16; ApoB HR 1.12 per SD, 95% CI 1.07-1.17), and a simultaneous 1-SD increase in both biomarkers conferred 22% higher MACE risk. Associations were endpoint-specific: ApoB was strongest for MI (HR 1.20, 1.14-1.27), IL-6 for cardiovascular death (HR 1.20, 1.12-1.29) and all-cause mortality (HR 1.17, 1.14-1.20). In categorical analyses, MACE risk rose stepwise relative to the Low IL-6, Low ApoB reference: HR 1.22 (95% CI 1.05-1.41) for high ApoB alone, 1.33 (95% CI 1.15-1.55) for high IL-6 alone, and 1.55 (95% CI 1.34-1.78) for both.
CONCLUSION
IL-6 and ApoB were independently associated with cardiovascular events, with atherogenic lipoprotein burden predominating for MI and inflammatory signaling for cardiovascular and all-cause death.
P. Cheon, J. McParland, Sean Doherty et al.· Progress in cardiovascular d...· 0 citations
Cardiovascular disease (CVD) is the leading cause of death and disability globally. Thus, prevention efforts aimed at reducing CVD events allow for greater functional independence and wellbeing over the course of life. Low-density lipoprotein-cholesterol is causally associated with atherosclerosis and is the primary target for atherosclerotic CVD (ASCVD) prevention. More recently, low-grade systemic inflammation has been recognized for its role in atherosclerotic disease initiation and progression. Additionally, there is compelling evidence for combined assessments of lipid and inflammatory biomarkers to predict long-term CVD events and guide prevention efforts early in life. In the context of CVD prevention, there have also been population shifts in CVD risk factor prevalence. Obesity prevalence has increased drastically over the last three decades, contributing to disability, lower life expectancy, and higher risk of CVD through multiple mechanisms. Specifically, obesity leads to a more atherogenic lipid profile and higher levels of systemic inflammation. The purpose of this review is to synthesize available literature on the interplay between obesity, dyslipidemia, and inflammation with CVD and how optimization of these risk factors is critical for healthy aging and longevity.
R. Rikhi, Michael D. Shapiro· Progress in cardiovascular d...· 0 citations
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F. Garagoli, L. Slipczuk, Michael D. Shapiro et al.· European Heart Journal· 0 citations
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