Publication Date

11-9-2023

Journal

European Journal of Preventive Cardiology

DOI

10.1093/eurjpc/zwad197

PMID

37306504

PMCID

PMC10637765

PubMedCentral® Posted Date

6-12-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Aged, Aged, 80 and over, Humans, Atherosclerosis, Atrial Fibrillation, Biomarkers, Brain Ischemia, C-Reactive Protein, Cardiovascular Diseases, Coronary Disease, Heart Failure, Interleukin-18, Interleukin-6, Natriuretic Peptide, Brain, Peptide Fragments, Prospective Studies, Risk Factors, Stroke, Cardiovascular disease, Inflammation, Ageing, Interleukin-6, Interleukin-18

Abstract

AIMS: Interleukin-6 (IL-6) and interleukin-18 (IL-18), important cytokines implicated in atherosclerosis and inflammaging, were assessed for associations with global cardiovascular disease (CVD), atrial fibrillation (AF), and death in older adults.

METHODS AND RESULTS: Participants from Atherosclerosis Risk in Communities study Visit 5 (mean age 75.4 ± 5.1 years) with IL-6 and IL-18 measurements were included (n = 5672). Cox regression models were used to assess associations of IL-6 and IL-18 with coronary heart disease (CHD), ischaemic stroke, heart failure (HF) hospitalization, global CVD (composite of CHD, stroke, and HF), AF, and all-cause death. Over a median follow-up of 7.2 years, there were 1235 global CVD events, 530 AF events, and 1173 deaths. Higher IL-6 [hazard ratio (HR) 1.57, 95% confidence interval (CI) 1.44-1.72 per log unit increase] and IL-18 (HR 1.13, 95% CI 1.01-1.26) were significantly associated with global CVD after adjustment for cardiovascular risk factors. Association between IL-6 and global CVD remained significant after further adjustment for high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity troponin T (hs-TnT) but was no longer significant for IL-18 after further adjustments. Interleukin-6 was also associated with increased risk for CHD, HF, and AF after adjustment for covariates. Both IL-6 and IL-18 were associated with increased risk for all-cause death independent of cardiovascular risk factors and other biomarkers.

CONCLUSION: Among older adults, both IL-6 and IL-18 were associated with global CVD and death. The association between IL-6 with CVD appears to be more robust and was independent of hs-CRP, NT-proBNP, and hs-TnT.

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