on October 23, 2003
Published online before print October 23, 2003, doi: 10.1161/01.ATV.0000102924.11767.8D
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on September 29, 2003
Accepted on October 6, 2003
Inflammation-Sensitive Plasma Proteins and Incidence of Myocardial Infarction in Men With Low Cardiovascular Risk
Gunnar Engström *;
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
* To whom correspondence should be addressed. 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