Author + information
- Aris Bechlioulisa,b,
- Katerina K. Nakaa,b,
- Lynn Doucette-Stamma,b,
- Leon Wilkinsa,b,
- Aikaterini Marinia,b,
- Sophia Giannitsia,b,
- John Rogusa,b,
- Kenneth Kornmana,b,
- Joseph L. Witztuma,b,
- Sotirios Tsimikasa,b and
- Lampros K. Michalisa,b
Background: Pro-inflammatory Interleukin-1 (IL-1) genotypes have been related to an increased risk of angiographic coronary artery disease (CAD) that is mediated by inflammation markers such as lipoprotein(a)[Lp(a)] and oxidized phospholipids(OxPL-apoB) in non-diabetic patients. Since the IL-1 genotype has been associated with greater expression of IL-1β and higher blood levels of C-reactive protein (hsCRP), we investigated whether IL-1 genotype status may also affect the relationship of hsCRP with angiographic CAD and cardiovascular events.
Methods: We enrolled 1,084 patients (mean age 65 years, 70% males, 44% diabetics) undergoing diagnostic coronary angiography. Serum hsCRP levels were measured and the composite genotype IL-1(+) was defined by 3 single-nucleotide polymorphisms in the IL-1 gene cluster. Angiographic CAD was diagnosed as a >50% stenosis in a coronary artery. Cardiovascular death, non-fatal myocardial infarction and stroke (n=77) were assessed after a median follow-up of 43 months (range 24-68).
Results: Higher hsCRP was associated with a higher CAD risk (OR 2.98, p<0.001) in the entire population. This relation was accentuated in IL-1(-) patients in both diabetic (OR 13.00, p<0.001) and non-diabetic patients (OR 10.45, p<0.001). The interaction between hsCRPlevels and the IL-1 genotype status was significant in older (≥60 years old)(p=0.041 for diabetics, p<0.001 for non-diabetics), but not in younger patients (p>0.05 for both diabetic and non-diabetics). After adjustment for risk factors, hsCRPlevels remained an independent predictor of CAD presence in diabetic and non-diabetic populations (p<0.001 for both), but were not significantly associated with cardiovascular events in either non-diabetic (p=0.211) or diabetic patients (p=0.065).
Conclusions: Higher hsCRP levels were significantly associated with angiographic CAD but not with cardiovascular events. This effect was more pronounced in genotype IL-1 negative and older patients (≥60 years old) in both diabetic and non-diabetic patients. These findings probably indicate that IL-1 genotype may mediate increased cardiovascular risk via inflammatory pathways that do not involve hsCRP.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-347
- 2017 American College of Cardiology Foundation