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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:2247.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Inflammation-Sensitive Plasma Proteins and Incidence of Myocardial Infarction in Men With Low Cardiovascular Risk

Gunnar Engström; Lars Stavenow; Bo Hedblad; Peter Lind; Patrik Tydén; Lars Janzon; Folke Lindgärde

From the Departments of Community Medicine (G.E., B.H., P.T., L.J.), Internal Medicine (L.S., P.L.), Vascular Diseases (F.L.), and Cardiology (P.T.), Malmö University Hospital, Malmö, Sweden.

Correspondence to Gunnar Engström, MD, PhD, Department of Community Medicine, Malmö University Hospital, S-20502 Malmö, Sweden. E-mail Gunnar.Engstrom{at}smi.mas.lu.se

Objective— Myocardial infarction (MI) is sometimes experienced by individuals without any traditional risk factor. This prospective study explored whether incidence of MI in nonsmoking, nondiabetic men with normal blood pressure and serum lipids is related to inflammation-sensitive plasma proteins (ISPs).

Methods and Results— Five ISPs (1-antitrypsin, haptoglobin, ceruloplasmin, fibrinogen, orosomucoid) were analyzed in 6075 men, 47±3.6 years old. A low-risk group (no traditional risk factor, n=1108) and a high-risk group (2 major risk factors, n=1011) were defined. Incidence of MI (n=227) was monitored over 18.1±4.3 years of follow-up. In the low-risk group, the age-adjusted relative risks (RRs) were 1.00 (reference), 1.9 (95% CI, 0.8 to 4.2), 1.8 (95% CI, 0.6 to 5.4), and 2.9 (95% CI, 1.05 to 8.1), respectively, for men with 0, 1, 2 and 3 ISPs in the top quartile (trend: P=0.03). In this group, the increased risk was observed only after 10 years of follow-up. In the high-risk group, the age-adjusted RRs were 1.00, 1.4 (95% CI, 0.9 to 2.2), 1.9 (95% CI, 1.2 to 3.1), and 2.0 (95% CI, 1.3 to 3.1), respectively, for men with 0, 1, 2, and 3 ISPs in the top quartile (trend: P=0.0004).

Conclusion— Incidence of MI in nonsmoking, nondiabetic men with normal blood pressure and lipids was related to ISPs. The causes for this relationship remain to be explored.

Key Words: myocardial infarction • inflammation • epidemiology • risk factors

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