Interleukin-6 and activin A are independently associated with cardiovascular events and mortality in type 2 diabetes: the prospective Asker and Bærum Cardiovascular Diabetes (ABCD) cohort study

Cardiovascular Diabetology

Original Investigation

Knut Endresen¹  Svend Aakhus¹  Lars Gullestad²  Kåre I Birkeland³  Elsa Orvik⁴  Anne Pernille Ofstad⁴  Odd Erik Johansen⁴  Thor Ueland⁵  Pål Aukrust⁶  Morten W Fagerland⁷ 

[1] Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway;Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway;K.G.Jebsen Cardiac Research Centre and Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway;Department of Endocrinology, Obesity and Preventive medicine, Oslo University Hospital Aker, Oslo, Norway;Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, N-1309 Rud, Bærum, Norway;Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway;Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway;Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Unit of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway;

关键词: Type 2 diabetes;    Cardiovascular event;    MACE;    Inflammatory marker;    Cardiovascular risk;    Risk prediction;   

DOI  :  10.1186/1475-2840-12-126

 received in 2013-07-04, accepted in 2013-08-26,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundNovel and robust cardiovascular (CV) markers are needed to improve CV morbidity and mortality risk prediction in type 2 diabetes (T2D). We assessed the long term predictive value of 4 novel CV risk markers for major CV events and mortality.MethodsWe included patients with T2D who had cytokines (interleukin [IL]-6 and activin A [actA]), a maximum stress ECG test (evaluated by the normalization pattern in early recovery phase) and echocardiography (evaluated by a measure of the left ventricular filling pressure - E/Em) assessed at baseline. The primary endpoint was time to first of any of the following events: myocardial infarction, stroke, hospitalization for unstable angina pectoris and death. All outcomes were adjudicated by independent experts. We used Cox proportional hazard modeling, Harrell C-statistic and the net reclassification improvement (NRI) to assess the additional value beyond conventional markers (age, gender, prior CV disease, HDL, creatinine, diastolic BP, microalbuminuria).ResultsAt baseline the study cohort (n = 135, mean age/diabetes duration/HbA1c: 59 yrs/7 yrs/7.6% [59 mmol/mol], 26% females) had moderate elevated CV risk (42% microalbuminuria, mean Framingham 10 year CV-risk 9.6%). During 8.6 yrs/1153.7 person years, 26 patients experienced 36 events. All 4 novel risk markers were significantly associated with increased risk of the primary endpoint, however, only IL-6 and actA improved C-statistic and NRI (+0.119/43.2%, +0.065/20.3% respectively) compared with the conventional CV risk factors.ConclusionsIL-6 and actA may provide prognostic information on CV events and mortality in T2D beyond conventional CV risk factors.Trial registrationClinicalTrials.gov:NCT00133718

【 授权许可】

CC BY   
© Ofstad et al.; licensee BioMed Central Ltd. 2013