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

Jefferis, BJ; Wannamethee, SG; Whincup, PH; Welsh, P; Rumley, A; Lowe, GDO; Ebrahim, S; (2013) Prospective study of IL-18 and risk of MI and stroke in men and women aged 60-79years: A nested case-control study. Cytokine , 61 (2) 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. © 2012 Elsevier Ltd.

Type: Article
Title: Prospective study of IL-18 and risk of MI and stroke in men and women aged 60-79years: A nested case-control study
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 under CC BY-NC-ND license.
Keywords: Coronary heart disease; Stroke; Interleukin-18; Epidemiology; Cohort
UCL classification: UCL
UCL > Provost and Vice Provost Offices
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
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/1399257
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