Circulating inflammatory markers and risks of cardiovascular and non-cardiovascular disease

Lowe, G.D.O. (2005) Circulating inflammatory markers and risks of cardiovascular and non-cardiovascular disease. Journal of Thrombosis and Haemostasis, 3(8), pp. 1618-1627. (doi: 10.1111/j.1538-7836.2005.01416.x)

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Abstract

There is current interest in the associations of circulating inflammatory markers (C-reactive protein, fibrinogen, white cell count, albumin, erythrocyte sedimentation rate, the factor VIII:von Willebrand factor complex, the tissue plasminogen activator:plasminogen activator inhibitor type 1 complex, fibrin D-dimer) not only with prognosis in acute coronary syndromes and acute stroke, but also in prediction of cardiovascular events in the general population. Recent meta-analyses of long-term prospective studies have established their associations with coronary heart disease (CHD) events, which may be cause, consequence or coincidence. These markers are also associated in epidemiologic studies of general populations with many cardiovascular risk factors (which may confound their associations with CHD risk), and also with asymptomatic arterial disease (of which they be consequences: ‘reverse causality’). The causality of their associations with cardiovascular events is questioned by their lack of specificity for risk of cardiovascular events; and by the lack of association of their functional genotypes with CHD in ‘Mendelian randomized trials’. Hence, proof of causality awaits testing in randomized-controlled trials of long-term selective reduction by future agents. Markers are of little additional predictive value to current cardiovascular risk scores, and it is premature to advocate their use in screening for cardiovascular risk prior to careful evaluation of costs, risks, and benefits.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lowe, Professor Gordon
Authors: Lowe, G.D.O.
Subjects:R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences
Journal Name:Journal of Thrombosis and Haemostasis
Publisher:Blackwell
ISSN:1538-7933
ISSN (Online):1538-7836
Published Online:08 August 2005

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