Vascular disease risk factors may predict mortality

listener · medicine forum Guru Joined: 05 May 2005 Posts: 617

NEW YORK - Whether elderly men have a high or low risk of dying in the next
four years can be estimated by using just two cardiovascular risk factors
-- plaque in the arteries of the neck and levels of interleukin-6 (IL-6),
an immune system protein that promotes inflammation, the results of a study
published in the American Journal of Medicine indicate.

"Ways to predict the risk of cardiovascular events or all-cause mortality
have largely been derived from populations in which old and very old
subjects were underrepresented," write Dr. Michiel L. Bots, of University
Medical Center Utrecht, the Netherlands, and colleagues.

The team therefore conducted a study to examine the usefulness of markers
of inflammation and the presence of arterial plaque (atherosclerosis) in
predicting all-cause and cardiovascular mortality in 403 men who were an
average of 78 years old at study entry.

The investigators evaluated the subjects for conventional cardiovascular
risk factors, as well as IL-6 and other proteins that promote inflammation.
Using ultrasound technology, they assessed plaque in the carotid arteries,
which are located in the neck and supply the brain with oxygen.

A total of 75 men (19 percent) died during 48 months of follow-up and the
cause of death was cardiovascular disease in 31 subjects. The average time
to death from the start of the study was 30 months.

The combination of high levels of IL-6 and number of carotid plaques
identified whether the men had a low or a high risk of mortality.

On the other hand, conventional risk factors, including age, cholesterol
level, blood pressure and diabetes, were poor predictors of mortality in
this age group.

SOURCE: American Journal of Medicine, June 2006.

Juhana Harju · medicine forum Guru Joined: 06 May 2005 Posts: 1056

listener wrote:

: NEW YORK - Whether elderly men have a high or low risk of dying in
: the next four years can be estimated by using just two cardiovascular
: risk factors -- plaque in the arteries of the neck and levels of
: interleukin-6 (IL-6), an immune system protein that promotes
: inflammation, the results of a study published in the American
: Journal of Medicine indicate.

Thanks for posting, that was interesting. Here is the abstract:

Am J Med. 2006 Jun;119(6):519-25.
Prediction of mortality risk in the elderly.
Stork S, Feelders RA, van den Beld AW, Steyerberg EW, Savelkoul HF, Lamberts
SW, Grobbee DE, Bots ML.

Julius Center for Health Sciences and Primary Care, University Medical
Center Utrecht, Utrecht, The Netherlands.

PURPOSE: Ways to predict the risk of cardiovascular (CV) events or all-cause
mortality have largely been derived from populations in which old and very
old subjects were underrepresented. We set out to estimate the incremental
prognostic utility of inflammation and atherosclerosis markers in the
prediction of all-cause and CV mortality in elderly men. METHODS: In a
prospective population-based cohort study, conventional CV risk factors were
documented in 403 independently living elderly men. C-reactive protein (CRP)
and interleukin (IL)-6 levels were measured. Carotid plaques were assessed
by ultrasound. Analyses were performed with proportional hazards analyses,
and bootstrapping was used for internal validation. Main outcome was CV and
all-cause mortality occurring during 4 years of follow-up. RESULTS:
Increasing tertiles of CRP, IL-6, and number of plaques were independently
associated with all-cause and CV mortality. With information on age, carotid
plaques, IL-6, and CRP yielded good discriminatory power for all-cause and
CV mortality: area under the receiver operating characteristic curve (95%
confidence interval), 0.76 (0.70-0.82) and 0.74 (0.68-0.80), respectively.
Combined use of only IL-6 and plaque burden allowed identification of
subjects with low and high mortality risk. The Framingham PROCAM and a Dutch
Risk Function poorly predicted mortality risk, similar or worse than a model
using age alone. CONCLUSION: In the old and very old, IL-6 and number of
carotid plaques are powerful predictors of mortality risk in the years to
come. Conventional risk scores seem to perform unsatisfactorily. PMID:
16750966

http://tinyurl.com/fcab9

--
Juhana

nospam7@heartmdphd.com · medicine forum Guru Joined: 27 Dec 2005 Posts: 470

Juhana Harju wrote:

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