Researchers Find Association between Inflammatory States and Early Development of Atherosclerosis
A multidisciplinary group of Miller School of Medicine researchers has identified an important association between baseline inflammatory states in asymptomatic patients and early development of coronary artery disease. The investigators studied the effects of multiple risk markers of inflammation, including anti-heat shock protein-60 (HSP60), interleukin-2, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) and their association with atherogenesis using the large multi-ethnic study of atherosclerosis (MESA).
The results have been published in the Online First edition of Heart: British Medical Journal as “Association between Anti-Human Shock Protein-60 and Interleukin-2 (IL-2) with Coronary Artery Calcium Score.”
“There is increasing evidence that inflammation plays an important role in the development and progression of atherogenesis,” said Abdulla A. Damluji, M.D., a third-year cardiology fellow and the paper’s first author. “We have found that inflammatory biomarkers may have a prognostic role in cardiovascular disease, particularly in early detection in asymptomatic patients.”
The researchers discovered that higher tertiles of anti-HSP60, IL-2, IL-6 and TNF-α were associated with significantly higher baseline coronary artery calcium (CAC) scores, a surrogate marker of early atherosclerotic disease, even after adjusting for known cardiovascular risk factors. There was a significant progression of CAC score on follow-up examination. Patients with higher IL-2, IL-6 and TNF-α values were at increased risk for unadjusted mortality after more than five years of follow-up. The researchers concluded that inflammatory biomarkers may have a prognostic role in atherosclerosis, particularly in the early detection of asymptomatic disease.
“This research offers a potential method for the risk stratification of apparently healthy adults and points to new opportunities for research in this important area,” said Robert C. Hendel, M.D., interim Chief of the Cardiovascular Division and one of the study’s co-authors.
The study’s corresponding author, Robert J. Myerburg, M.D., professor of medicine and physiology, and the American Heart Association Chair in Cardiovascular Research, added, “Risk prediction in the individual patient remains a major challenge in the practice of medicine. Studies of this type are starting points for new approaches that can have both clinical and healthcare-cost implications.”
Other Miller School researchers in the study included Archana Ramireddy, M.D., third-year internal medicine resident; Lynda Otalvaro, M.D., and George R. Marzouka, M.D., both third-year cardiology fellows; Juan Viles-Gonzalez, M.D., assistant professor of medicine; Chunming Dong, M.D., associate professor of medicine; Carlos E. Alfonso, M.D., assistant professor of medicine; Mauricio G. Cohen, M.D., associate professor of medicine; Nanette H. Bishopric, M.D., professor of pharmacology, medicine and pediatrics; and former Miller School faculty member Mauro Moscucci, M.D., M.B.A.