Do inflammatory biomarkers add to the discrimination of cardiovascular disease after allowing for social deprivation? Results from a 10-year cohort study in Glasgow, Scotland

Woodward, M., Welsh, P. , Rumley, A., Tunstall-Pedoe, H. and Lowe, G. D. O. (2010) Do inflammatory biomarkers add to the discrimination of cardiovascular disease after allowing for social deprivation? Results from a 10-year cohort study in Glasgow, Scotland. European Heart Journal, 31(21), pp. 2669-2675. (doi:10.1093/eurheartj/ehp115)

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Publisher's URL: http://dx.doi.org/10.1093/eurheartj/ehp115

Abstract

To assess the additional discriminative value of adding each of five inflammatory biomarkers to the ASSIGN risk score, which includes social deprivation. In this study, 1319 men and women aged 25-64 in the fourth Glasgow MONICA study were followed-up for cardiovascular endpoints. Baseline C-reactive protein, fibrinogen, IL-6, IL-18, and TNF alpha were related to risk of CVD. The discriminative value of adding each to the ASSIGN score was assessed using area under the receiver operating characteristic (AUC) and relative integrated percentage improvement in classification (RIDI). During a median of 10.5 years, 151 CVD events occurred. After adjusting for ASSIGN variables, each inflammatory marker except IL-18 had a significant (P < 0.05) association with CVD risk. The AUC using ASSIGN [0.799 (95% CI 0.790-0.809)] was improved by the inclusion of C-reactive protein and TNF alpha [0.805 (95% CI 0.795-0.815); P < 0.03], but not by other combinations. C-reactive protein and TNF alpha yielded a significant RIDI (IL-6 almost so). C-reactive protein and TNF alpha together improved the classification of risk by 11% (95% CI, 3-19%) when added to the ASSIGN variables. Some inflammatory biomarkers add moderate discriminative information to the ASSIGN CVD risk score. The clinical utility of this information, cost-effectiveness, and optimization should be assessed in future studies.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Rumley, Dr Ann and Lowe, Professor Gordon and Welsh, Dr Paul
Authors: Woodward, M., Welsh, P., Rumley, A., Tunstall-Pedoe, H., and Lowe, G. D. O.
College/School:College of Medical Veterinary and Life Sciences
Journal Name:European Heart Journal
ISSN:0195-668X

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