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

作者：Jennifer K. Pai, Tobias Pischon, Jing Ma, JoAnn E. Manson, Susan E. Hankinson, KAUMUDI J. JOSHIPURA, Gary C. Curhan, Nader Rifai, Carolyn C. Cannuscio, Meir J. Stampfer, Eric B. Rimm · 发表于：New England Journal of Medicine · 年份：2004 · DOI：10.1056/nejmoa040967 · 被引用次数：1181 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Immune Response and Inflammation、Inflammatory Biomarkers in Disease Prognosis

BACKGROUND: Few studies have simultaneously investigated the role of soluble tumor necrosis factor alpha (TNF-alpha) receptors types 1 and 2 (sTNF-R1 and sTNF-R2), C-reactive protein, and interleukin-6 as predictors of cardiovascular events. The value of these inflammatory markers as independent predictors remains controversial. METHODS: We examined plasma levels of sTNF-R1, sTNF-R2, interleukin-6, and C-reactive protein as markers of risk for coronary heart disease among women participating in the Nurses' Health Study and men participating in the Health Professionals Follow-up Study in nested case-control analyses. Among participants who provided a blood sample and who were free of cardiovascular disease at baseline, 239 women and 265 men had a nonfatal myocardial infarction or fatal coronary heart disease during eight years and six years of follow-up, respectively. Using risk-set sampling, we selected controls in a 2:1 ratio with matching for age, smoking status, and date of blood sampling. RESULTS: After adjustment for matching factors, high levels of interleukin-6 and C-reactive protein were significantly related to an increased risk of coronary heart disease in both sexes, whereas high levels of soluble TNF-alpha receptors were significant only among women. Further adjustment for lipid and nonlipid factors attenuated all associations; only C-reactive protein levels remained significant. The relative risk among all participants was 1.79 for those with C-reactive protein l...