03070nas a2200445 4500008004100000022001400041245015700055210006900212260001300281300001100294490000800305520172400313653005102037653002202088653000902110653001502119653002302134653002802157653002102185653002102206653004002227653001102267653001102278653001402289653001702303653001802320653000902338653001602347653003202363653002402395653001702419100002202436700002202458700001702480700002202497700002702519700002202546700002002568856003602588 2013 eng d a1879-148400aImpact of inflammatory biomarkers on relation of high density lipoprotein-cholesterol with incident coronary heart disease: cardiovascular Health Study.0 aImpact of inflammatory biomarkers on relation of high density li c2013 Dec a246-510 v2313 a

BACKGROUND: Inflammatory factors and low HDL-C relate to CHD risk, but whether inflammation attenuates any protective association of high HDL-C is unknown.

OBJECTIVE: Investigate inflammatory markers' individual and collective impact on the association of HDL-C with incident coronary heart disease (CHD).

METHODS: In 3888 older adults without known cardiovascular disease (CVD), we examined if the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA₂) modify the relation of HDL-C with CHD. HDL-C, CRP, IL-6, and Lp-PLA₂ values were grouped as using gender-specific tertiles. Also, an inflammation index of z-score sums for CRP, IL-6, and Lp-PLA₂ was categorized into tertiles. We calculated CHD incidence for each HDL-C/inflammation group and performed Cox regression, adjusted for standard CVD risk factors and triglycerides to examine the relationship of combined HDL-C-inflammation groups with incident events.

RESULTS: CHD incidence (per 1000 person years) was higher for higher levels of CRP, IL-6, and the index, and lower for higher levels of HDL-C. Compared to high HDL-C/low-inflammation categories (referent), adjusted HRs for incident CHD were increased for those with high HDL-C and high CRP (HR = 1.50, p < 0.01) or highest IL-6 tertile (HR = 1.40, p < 0.05), but not with highest Lp-PLA₂ tertile. Higher CHD incidence was similarly seen for those with intermediate or low HDL-C accompanied by high CRP, high IL-6, or a high inflammatory index.

CONCLUSION: The protective relation of high HDL-C for incident CHD appears to be attenuated by greater inflammation.

10a1-Alkyl-2-acetylglycerophosphocholine Esterase10aAfrican Americans10aAged10aBiomarkers10aC-Reactive Protein10aCardiovascular Diseases10aCholesterol, HDL10aCoronary Disease10aEuropean Continental Ancestry Group10aFemale10aHumans10aIncidence10aInflammation10aInterleukin-610aMale10aMiddle Aged10aProportional Hazards Models10aProspective Studies10aRisk Factors1 aTehrani, David, M1 aGardin, Julius, M1 aYanez, David1 aHirsch, Calvin, H1 aLloyd-Jones, Donald, M1 aStein, Phyllis, K1 aWong, Nathan, D uhttps://chs-nhlbi.org/node/616702323nas a2200217 4500008004100000022001400041245013100055210006900186260001600255520161200271100002201883700001601905700001701921700001901938700002201957700002001979700003001999700002002029700002002049856003602069 2019 eng d a1941-722500aTrends in Blood Pressure and High-Sensitivity Cardiac Troponin-T with Cardiovascular Disease: The Cardiovascular Health Study.0 aTrends in Blood Pressure and HighSensitivity Cardiac TroponinT w c2019 Jun 213 a

BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is individually associated with incident hypertension (HTN) and cardiovascular disease (CVD) events. We hypothesize that the increases in hs-cTnT with increases in blood pressure will be related to higher incidence of CVD.

METHODS: The Cardiovascular Health Study is a longitudinal cohort of older adults. Those with hs-cTnT data and CVD risk factors at baseline and follow-up (2-3 years later) were stratified based on systolic blood pressure (SBP) (optimal: <120 mmHg, intermediate: 120-139 mmHg, elevated: ≥140 mmHg) and hs-cTnT (undetectable: <5 ng/L, detectable: 5-13 ng/L, elevated: ≥14 ng/L) categories. SBP and hs-cTnT were classified as increased or decreased if they changed categories between exams, and stable if they did not. Cox regression evaluated incident CVD events over an average 9 year follow-up.

RESULTS: Among 2219 adults, 510 (23.0 %) had decreased hs-cTnT, 1,279 (57.6 %) had stable hs-cTnT, and 430 (19.4 %) had increased hs-cTnT. Those with increased hs-cTnT had a higher CVD risk with stable SBP (HR: 1.28 [1.04-1.57], p=0.02) or decreased SBP (HR: 1.57 [1.08-2.28], p=0.02) compared to those within the same SBP group but a stable hs-cTnT. In those with lower SBP at follow-up, there was an inverse relation between DBP and risk of CVD events in those with increased hs-cTnT (HR: 0.44 per 10 mmHg increase, p<0.01).

CONCLUSION: An increase in hs-cTnT over time is associated with a higher risk of CVD even when the blood pressure is stable or decreases over time.

1 aTehrani, David, M1 aFan, Wenjun1 aNambi, Vijay1 aGardin, Julius1 aHirsch, Calvin, H1 aAmsterdam, Ezra1 adeFilippi, Christopher, R1 aPolonsky, Tamar1 aWong, Nathan, D uhttps://chs-nhlbi.org/node/8108