Inflammation is a risk factor for major adverse cardiovascular events (MACE). Elevated levels of both high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL6) have been associated with MACE. However, few studies have compared IL6 to hsCRP for cardiovascular risk assessment. Using the MESA (Multi-Ethnic Study of Atherosclerosis) study cohort, we aim to compare IL6 to hsCRP. We divided IL6 and hsCRP by their median values and created 4 groups i.e., low-low, high-low, low-high and high-high. The median follow-up was 14 years. 6614 (97 %) participants had complete baseline IL6 and hsCRP data. The correlation between hsCRP and IL6 was modest (Rho = 0.53). IL6 ≥1.2 pg/mL (median) was present in 3309 participants, and hsCRP ≥1.9 mg/L (median) was present in 3339 participants. Compared to participants with low IL6 and low hsCRP, those with high IL6 and high hsCRP were older (64 60 years), more frequently women (63 % 45 %), and with more cardiovascular co-morbidities. hsCRP outcome associations lost statistical significance when adjusting for IL6: MACE HR (95 %CI) 1.06 (0.93–1.20), 0.39, whereas IL6 associations remained significant after adjusting for hsCRP: HR (95 %CI) 1.44 (1.25–1.64), 0.001. The C-index of Framingham score for did not improve with hsCRP but improved with IL6. Compared to participants with low IL6 and low hsCRP, those with high IL6, regardless of hsCRP, experienced an increased risk of MACE, heart failure and mortality. In a diverse and asymptomatic population, IL6 showed a stronger association with atherosclerotic, heart failure and fatal outcomes than hsCRP.

中文翻译：

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白介素 6 和高敏 C 反应蛋白用于心血管风险评估的比较：MESA 研究结果

炎症是主要不良心血管事件（MACE）的危险因素。高敏 C 反应蛋白 (hsCRP) 和白细胞介素 6 (IL6) 水平升高与 MACE 相关。然而，很少有研究将 IL6 与 hsCRP 进行心血管风险评估的比较。使用 MESA（动脉粥样硬化多种族研究）研究队列，我们​​的目的是将 IL6 与 hsCRP 进行比较。我们将 IL6 和 hsCRP 除以中值，并创建 4 组，即低-低、高-低、低-高和高-高。中位随访时间为 14 年。6614 名 (97%) 参与者拥有完整的基线 IL6 和 hsCRP 数据。hsCRP 和 IL6 之间的相关性不大 (Rho = 0.53)。3309 名参与者中 IL6 ≥1.2 pg/mL（中位数），3339 名参与者中 hsCRP ≥1.9 mg/L（中位数）。与低 IL6 和低 hsCRP 的参与者相比，高 IL6 和高 hsCRP 的参与者年龄更大（64 至 60 岁），女性更常见（63 % 45 %），并且患有更多心血管并发症。调整 IL6 后，hsCRP 结果关联失去统计学意义：MACE HR (95%CI) 1.06 (0.93–1.20)、0.39，而调整 hsCRP 后，IL6 关联仍然显着：HR (95%CI) 1.44 (1.25–1.64)、 0.001。Framingham 评分的 C 指数并未因 hsCRP 而改善，但因 IL6 而改善。与IL6和hsCRP低的参与者相比，IL6高的参与者，无论hsCRP如何，发生MACE、心力衰竭和死亡率的风险都会增加。在多样化和无症状的人群中，IL6 与动脉粥样硬化、心力衰竭和致命结果的相关性比 hsCRP 更强。