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Prospective study of IL-18 and risk of MI and stroke in men and women aged 60-79 years: a nested case-control study

Jefferis, BJ; Whincup, PH; Welsh, P; Wannamethee, SG; Rumley, A; Ebrahim, S; Lawlor, DA; (2013) Prospective study of IL-18 and risk of MI and stroke in men and women aged 60-79 years: a nested case-control study. Cytokine , 61 (2) pp. 513-520. 10.1016/j.cyto.2012.10.010. Green open access

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Abstract

Aim: IL-18 is hypothesized to destabilise atherosclerotic plaques, leading to thrombotic events and epidemiologic studies suggest that IL-18 may increase risk of CHD or CVD. We examined prospective associations between levels of serum IL-18 and new CHD and stroke events in older men and women from a general population. / Methods: A case-control study was nested within a prospective cohort of men and women aged 60–79 years recruited from general practices in 25 British towns in 1998–2000 and followed-up for 7.5 years for fatal and non-fatal MI and stroke. Baseline IL-18 was measured in stored serum samples of incident cases of MI (n = 364) or stroke (n = 300) and two controls per case. / Results: Geometric mean IL-18 levels were higher among the 364 MI cases than the 706 controls; 417.84 pg/mL (IQR 316.25, 537.44) compared to 386.90 pg/mL (IQR 296.54, 482.33), p(difference) = 0.002. IL-18 was positively associated with adverse lipid and inflammatory profiles. Men and women in the top third of baseline IL-18 levels had an age and sex-adjusted odds ratio (OR) for MI of 1.31 (95%CI 0.92, 1.85) compared with those in the lowest third; this attenuated to 1.05 (95%CI 0.72, 1.53) after additional adjustment for established vascular and inflammatory risk factors. Each doubling of IL-18 level was associated with an increased OR for MI 1.34 (95%CI 1.04, 1.72), which was attenuated on adjustment for established vascular and inflammatory risk factors; 1.09 (95%CI 0.83, 1.44). Geometric mean IL-18 levels did not differ between stroke cases and controls. The OR for stroke associated with the highest compared to the lowest tertile of IL-18 was 1.24 (95%CI 0.84, 1.84). Results for MI and stroke did not differ by presence of pre-existing CVD, gender or age. / Conclusions: Circulating IL-18 levels were strongly associated with a range of established and novel risk factors but were not independently associated with risk of MI or stroke in our study.

Type: Article
Title: Prospective study of IL-18 and risk of MI and stroke in men and women aged 60-79 years: a nested case-control study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.cyto.2012.10.010
Publisher version: http://dx.doi.org/10.1016/j.cyto.2012.10.010
Language: English
Additional information: Copyright © 2012 Elsevier Ltd. Open Access funded by British Heart Foundation. Under a Creative Commons license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
Keywords: Aged, Case-Control Studies, Female, Humans, Interleukin-18, Male, Middle Aged, Myocardial Infarction, Odds Ratio, Prospective Studies, Regression Analysis, Risk Factors, Stroke
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1380555
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