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- Title
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.
- Authors
Ofstad, Anne Pernille; Gullestad, Lars; Orvik, Elsa; Aakhus, Svend; Endresen, Knut; Ueland, Thor; Aukrust, Pål; Fagerland, Morten W.; Birkeland, Kåre I; Johansen, Odd Erik
- Abstract
Background: Novel 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. Methods: We 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). Results: At 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. Conclusions: IL-6 and actA may provide prognostic information on CV events and mortality in T2D beyond conventional CV risk factors.
- Subjects
INTERLEUKIN-6; DIABETES; ECHOCARDIOGRAPHY; CORONARY disease; CYTOKINES; MYOCARDIAL infarction; TRANSFORMING growth factors-beta
- Publication
Cardiovascular Diabetology, 2013, Vol 12, Issue 1, p1
- ISSN
1475-2840
- Publication type
Article
- DOI
10.1186/1475-2840-12-126