Comparison of interleukin-6 and high-sensitivity C-reactive protein for cardiovascular risk assessment: Findings from
João Pedro Ferreira1, Francisco Vasques-Nóvoa2, João Sérgio Neves2
1UnIC@RISE, Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Centre d'Investigations Cliniques Plurithématique 1433, INSERM, Université de Lorraine, Nancy, France.
Insights
Interleukin-6 (IL6) demonstrates a stronger association with cardiovascular events and mortality than high-sensitivity C-reactive protein (hsCRP). This finding suggests IL6 may be a more effective biomarker for assessing cardiovascular risk in asymptomatic populations.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Inflammation Research
Background:
- Inflammation is a known risk factor for major adverse cardiovascular events (MACE).
- Elevated levels of high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL6) are linked to MACE.
- Comparative studies on IL6 and hsCRP for cardiovascular risk assessment are limited.
Purpose of the Study:
- To compare the efficacy of IL6 and hsCRP in assessing cardiovascular risk.
- To investigate the association of IL6 and hsCRP with MACE in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
Main Methods:
- Categorized participants into four groups based on median IL6 and hsCRP levels (low-low, high-low, low-high, high-high).
- Analyzed associations between IL6, hsCRP, and MACE over a median follow-up of 14 years.
- Assessed the impact of IL6 and hsCRP on the Framingham risk score.
Main Results:
- IL6 and hsCRP showed a modest correlation (Rho = 0.53).
- Elevated IL6, independent of hsCRP, was significantly associated with increased risk of MACE, heart failure, and mortality.
- hsCRP associations with MACE lost statistical significance when adjusted for IL6, while IL6 associations remained significant after adjusting for hsCRP.
Conclusions:
- IL6 demonstrated a stronger association with atherosclerotic, heart failure, and fatal outcomes compared to hsCRP in a diverse, asymptomatic population.
- IL6 may serve as a more potent biomarker for cardiovascular risk stratification than hsCRP.
Background And Aims:
Inflammation is a risk factor for major adverse cardiovascular events (MACE). Elevated levels of both high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL6) have been associated with MACE. However, few studies have compared IL6 to hsCRP for cardiovascular risk assessment. Using the MESA (Multi-Ethnic Study of Atherosclerosis) study cohort, we aim to compare IL6 to hsCRP.
Methods:
We divided IL6 and hsCRP by their median values and created 4 groups i.e., low-low, high-low, low-high and high-high. The median follow-up was 14 years.
Results:
6614 (97 %) participants had complete baseline IL6 and hsCRP data. The correlation between hsCRP and IL6 was modest (Rho = 0.53). IL6 ≥1.2 pg/mL (median) was present in 3309 participants, and hsCRP ≥1.9 mg/L (median) was present in 3339 participants. Compared to participants with low IL6 and low hsCRP, those with high IL6 and high hsCRP were older (64 vs. 60 years), more frequently women (63 % vs. 45 %), and with more cardiovascular co-morbidities. hsCRP outcome associations lost statistical significance when adjusting for IL6: MACE HR (95 %CI) 1.06 (0.93-1.20), p =0.39, whereas IL6 associations remained significant after adjusting for hsCRP: HR (95 %CI) 1.44 (1.25-1.64), p <0.001. The C-index of Framingham score for did not improve with hsCRP but improved with IL6. Compared to participants with low IL6 and low hsCRP, those with high IL6, regardless of hsCRP, experienced an increased risk of MACE, heart failure and mortality.
Conclusions:
In a diverse and asymptomatic population, IL6 showed a stronger association with atherosclerotic, heart failure and fatal outcomes than hsCRP.
More Related Videos
08:51Author Spotlight: Integrated Multi-Omics Analysis for Unveiling Multicellular Immune Signatures in Clinical Heart Attack Cohorts
Published on: September 20, 2024
06:29Accurate and Simple Measurement of the Pro-inflammatory Cytokine IL-1β using a Whole Blood Stimulation Assay
Published on: March 1, 2011
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...