OBJECTIVE: The objective of this study was to examine the association of inflammatory markers with risk of first-ever cerebrovascular events (CVEs), while simultaneously evaluating subclinical vascular disease. METHODS AND RESULTS: We enrolled 464 outpatients who had vascular risk factors without any preexisting cardiovascular disease. We examined the presence of silent lacunar infarction (SLI) by magnetic resonance imaging; carotid intima-media thickness by ultrasound; and measured high-sensitivity C-reactive protein, interleukin (IL)-6, and IL-18 at baseline, and assessed their associations with CVEs using Cox proportional hazards models of 4.8±2.6 years follow-up. We further calculated measures of reclassification and discrimination. In age- and sex-adjusted analysis, IL-6, but neither high-sensitivity C-reactive protein nor IL-18, was associated with CVEs. The association remained significant after adjustment for conventional risk factors, intima-media thickness, and SLI (hazard ratios: 1.80, per 1-SD increase in log IL-6, P=0.03). Compared with the patients with below median IL-6 without SLI, those with above median IL-6 and SLI had a higher risk of CVEs (hazard ratios: 4.14, P=0.0014). The combination of IL-6 and SLI resulted in the net reclassification improvement of 14.3% (P=0.04), and the integrated discrimination improvement gain of 2.1% (P=0.05). CONCLUSIONS: IL-6 levels were independently associated with CVEs and could improve reclassification in those with SLI.
OBJECTIVE: The objective of this study was to examine the association of inflammatory markers with risk of first-ever cerebrovascular events (CVEs), while simultaneously evaluating subclinical vascular disease. METHODS AND RESULTS: We enrolled 464 outpatients who had vascular risk factors without any preexisting cardiovascular disease. We examined the presence of silent lacunar infarction (SLI) by magnetic resonance imaging; carotid intima-media thickness by ultrasound; and measured high-sensitivity C-reactive protein, interleukin (IL)-6, and IL-18 at baseline, and assessed their associations with CVEs using Cox proportional hazards models of 4.8±2.6 years follow-up. We further calculated measures of reclassification and discrimination. In age- and sex-adjusted analysis, IL-6, but neither high-sensitivity C-reactive protein nor IL-18, was associated with CVEs. The association remained significant after adjustment for conventional risk factors, intima-media thickness, and SLI (hazard ratios: 1.80, per 1-SD increase in log IL-6, P=0.03). Compared with the patients with below median IL-6 without SLI, those with above median IL-6 and SLI had a higher risk of CVEs (hazard ratios: 4.14, P=0.0014). The combination of IL-6 and SLI resulted in the net reclassification improvement of 14.3% (P=0.04), and the integrated discrimination improvement gain of 2.1% (P=0.05). CONCLUSIONS:IL-6 levels were independently associated with CVEs and could improve reclassification in those with SLI.
Authors: A Vilar-Bergua; I Riba-Llena; C Nafría; A Bustamante; V Llombart; P Delgado; J Montaner Journal: J Cereb Blood Flow Metab Date: 2016-01 Impact factor: 6.200
Authors: Iffat Rahman; Keith Humphreys; Anna Michaela Bennet; Erik Ingelsson; Nancy Lee Pedersen; Patrik Karl Erik Magnusson Journal: Eur J Epidemiol Date: 2013-07-09 Impact factor: 8.082
Authors: Andreas Papadopoulos; Konstantinos Palaiopanos; Harry Björkbacka; Annette Peters; James A de Lemos; Sudha Seshadri; Martin Dichgans; Marios K Georgakis Journal: Neurology Date: 2021-12-30 Impact factor: 9.910
Authors: Craig Balmforth; Job Jmh van Bragt; Titia Ruijs; James R Cameron; Robert Kimmitt; Rebecca Moorhouse; Alicja Czopek; May Khei Hu; Peter J Gallacher; James W Dear; Shyamanga Borooah; Iain M MacIntyre; Tom Mc Pearson; Laura Willox; Dinesh Talwar; Muriel Tafflet; Christophe Roubeix; Florian Sennlaub; Siddharthan Chandran; Baljean Dhillon; David J Webb; Neeraj Dhaun Journal: JCI Insight Date: 2016-12-08