Abstract
Background Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population. Methods Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses. Results Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p <0.001); 0.0072 mm for fibrinogen (p <0.001); and 0.0025 mm for leucocyte count (p = 0.033). 'Inflammatory load', defined as the number of elevated inflammatory markers (i.e. in upper two quintiles), showed a positive linear association with baseline CCA-IMT (p <0.001). Longitudinal associations of baseline inflammatory markers and changes therein with CCA-IMT progression were null or at most weak. Participants with the highest 'inflammatory load' had a greater CCA-IMT progression (p = 0.015). Conclusion Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 194-205 |
| Number of pages | 12 |
| Journal | European Journal of Preventive Cardiology |
| Volume | 23 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 1 2016 |
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Keywords
- atherosclerosis
- Inflammation
- meta-analysis
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Epidemiology
Cite this
Inflammatory markers and extent and progression of early atherosclerosis : Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration. / Willeit, Peter; Thompson, Simon G.; Agewall, Stefan; Bergström, Göran; Bickel, Horst; Catapano, Alberico L.; Chien, Kuo Liong; De Groot, Eric; Empana, Jean Philippe; Etgen, Thorleif; Franco, Oscar H.; Iglseder, Bernhard; Johnsen, Stein H.; Kavousi, Maryam; Lind, Lars; Liu, Jing; Mathiesen, Ellisiv B.; Norata, Giuseppe D.; Olsen, Michael H.; Papagianni, Aikaterini; Poppert, Holger; Price, Jackie F.; Sacco, Ralph L; Yanez, David N.; Zhao, Dong; Schminke, Ulf; Bülbül, Alpaslan; Polak, Joseph F.; Sitzer, Matthias; Hofman, Albert; Grigore, Liliana; Dörr, Marcus; Su, Ta Chen; Ducimetière, Pierre; Xie, Wuxiang; Ronkainen, Kimmo; Kiechl, Stefan; Rundek, Tatjana; Robertson, Christine; Fagerberg, Björn; Bokemark, Lena; Steinmetz, Helmuth; Ikram, M. Arfan; Völzke, Henry; Lin, Hung Ju; Plichart, Matthieu; Tuomainen, Tomi Pekka; Desvarieux, Moise; McLachlan, Stela; Schmidt, Caroline; Kauhanen, Jussi; Willeit, Johann; Lorenz, Matthias W.; Sander, Dirk.
In: European Journal of Preventive Cardiology, Vol. 23, No. 2, 01.01.2016, p. 194-205.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Inflammatory markers and extent and progression of early atherosclerosis
T2 - Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration
AU - Willeit, Peter
AU - Thompson, Simon G.
AU - Agewall, Stefan
AU - Bergström, Göran
AU - Bickel, Horst
AU - Catapano, Alberico L.
AU - Chien, Kuo Liong
AU - De Groot, Eric
AU - Empana, Jean Philippe
AU - Etgen, Thorleif
AU - Franco, Oscar H.
AU - Iglseder, Bernhard
AU - Johnsen, Stein H.
AU - Kavousi, Maryam
AU - Lind, Lars
AU - Liu, Jing
AU - Mathiesen, Ellisiv B.
AU - Norata, Giuseppe D.
AU - Olsen, Michael H.
AU - Papagianni, Aikaterini
AU - Poppert, Holger
AU - Price, Jackie F.
AU - Sacco, Ralph L
AU - Yanez, David N.
AU - Zhao, Dong
AU - Schminke, Ulf
AU - Bülbül, Alpaslan
AU - Polak, Joseph F.
AU - Sitzer, Matthias
AU - Hofman, Albert
AU - Grigore, Liliana
AU - Dörr, Marcus
AU - Su, Ta Chen
AU - Ducimetière, Pierre
AU - Xie, Wuxiang
AU - Ronkainen, Kimmo
AU - Kiechl, Stefan
AU - Rundek, Tatjana
AU - Robertson, Christine
AU - Fagerberg, Björn
AU - Bokemark, Lena
AU - Steinmetz, Helmuth
AU - Ikram, M. Arfan
AU - Völzke, Henry
AU - Lin, Hung Ju
AU - Plichart, Matthieu
AU - Tuomainen, Tomi Pekka
AU - Desvarieux, Moise
AU - McLachlan, Stela
AU - Schmidt, Caroline
AU - Kauhanen, Jussi
AU - Willeit, Johann
AU - Lorenz, Matthias W.
AU - Sander, Dirk
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population. Methods Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses. Results Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p <0.001); 0.0072 mm for fibrinogen (p <0.001); and 0.0025 mm for leucocyte count (p = 0.033). 'Inflammatory load', defined as the number of elevated inflammatory markers (i.e. in upper two quintiles), showed a positive linear association with baseline CCA-IMT (p <0.001). Longitudinal associations of baseline inflammatory markers and changes therein with CCA-IMT progression were null or at most weak. Participants with the highest 'inflammatory load' had a greater CCA-IMT progression (p = 0.015). Conclusion Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis.
AB - Background Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population. Methods Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses. Results Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p <0.001); 0.0072 mm for fibrinogen (p <0.001); and 0.0025 mm for leucocyte count (p = 0.033). 'Inflammatory load', defined as the number of elevated inflammatory markers (i.e. in upper two quintiles), showed a positive linear association with baseline CCA-IMT (p <0.001). Longitudinal associations of baseline inflammatory markers and changes therein with CCA-IMT progression were null or at most weak. Participants with the highest 'inflammatory load' had a greater CCA-IMT progression (p = 0.015). Conclusion Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis.
KW - atherosclerosis
KW - Inflammation
KW - meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=84953253796&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84953253796&partnerID=8YFLogxK
U2 - 10.1177/2047487314560664
DO - 10.1177/2047487314560664
M3 - Article
C2 - 25416041
AN - SCOPUS:84953253796
VL - 23
SP - 194
EP - 205
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 2
ER -