Inflammation and hemostasis biomarkers and cardiovascular risk in the elderly: the Cardiovascular Health Study
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1Department of Medicine, Brown University and Boston University, Providence, RI, USA.
Insights
Seven inflammation and hemostasis biomarkers predict cardiovascular disease (CVD) risk in older adults. C-reactive protein (CRP) showed particular promise for assessing CVD risk in this population.
Area of Science:
- Gerontology and Cardiovascular Health
- Biomarker Discovery and Disease Prediction
Background:
- Limited research exists on inflammation and hemostasis biomarkers in relation to cardiovascular disease (CVD) risk among older adults.
- Understanding these associations is crucial for developing targeted preventive strategies in aging populations.
Purpose of the Study:
- To evaluate the predictive value of multiple inflammation and hemostasis biomarkers for incident CVD in older individuals.
- To assess the combined effects of these biomarkers in CVD risk stratification.
Main Methods:
- Analysis of thirteen biomarkers including interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer, and homocysteine in 4510 participants from the Cardiovascular Health Study.
- Biomarkers were assessed as gender-specific SD increments and quintiles using proportional hazards models, adjusted for demographic and clinical risk factors.
- Exploration of biomarker combinations and their association with CVD events over a 9-year follow-up period.
Main Results:
- Seven biomarkers, including IL-6, CRP, D-dimer, homocysteine, leukocyte count (WBC), factor VIII, and lipoprotein(a), were significantly associated with incident CVD.
- Fibrinogen and soluble intercellular adhesion molecule-1 (sICAM-1) showed gender-specific associations with CVD risk.
- Combinatorial analysis indicated that elevated levels of multiple biomarkers, particularly when combined with low cholesterol/HDL, strongly predicted CVD, while low CRP attenuated risk.
Conclusions:
- Several inflammation and hemostasis biomarkers are independently associated with CVD risk in older adults.
- C-reactive protein (CRP) demonstrated notable predictive utility, suggesting potential advantages over other biomarkers.
- Further large-scale investigations are warranted to fully elucidate these biomarker associations and their clinical implications.
Background:
There are few studies of inflammation and hemostasis biomarkers and cardiovascular disease risk (CVD) in older adults.
Objectives:
To assess multiple biomarkers simultaneously and in combinations for CVD risk assessment in older individuals.
Patients/Methods:
Thirteen biomarkers, interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer, fibrinogen, factor VII, factor VIII, leukocyte count (WBC), platelet count, lipoprotein(a), soluble intercellular adhesion molecule-1 (sICAM-1), albumin, homocysteine and uric acid, were correlated with incident CVD in 4510 individuals in the Cardiovascular Health Study. Baseline biomarkers were analyzed as gender-specific SD increments and quintiles in proportional hazards models adjusted for demographics, CVD risk factors and medications.
Results:
Over 9 years with 1700 CVD events, seven biomarkers were associated with CVD. Adjusted hazard ratios (HRs, 95% CI) per SD increment were 1.16 (1.09, 1.23) for IL-6, 1.16 (1.09, 1.23) for CRP, 1.13 (1.05, 1.21) for D-dimer, 1.17 (1.09, 1.25) for homocysteine, 1.06 (1.00, 1.12) for WBC, 1.06 (1.00, 1.12) for factor VIII, and 1.07 (1.00, 1.13) for lipoprotein(a). Fibrinogen was associated with CVD in men only (HR 1.12, 95% CI 1.04, 1.22) and sICAM-1 in women only (HR 1.16, 95% CI 1.05, 1.27). IL-6 and CRP remained associated with CVD when modeled with WBC. Participants were classified by all combinations of two biomarkers being high or low (IL-6, CRP, WBC, factor VIII, cholesterol/HDL). All were associated with CVD when cholesterol/HDL was low and none when CRP was low.
Conclusions:
Seven biomarkers were associated with CVD in older adults, with CRP having some advantages compared with others. Even larger studies are needed to better characterize these associations.
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