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- Dokumenttyp:
- Article; Journal Article
- Autor(en):
- Georgakis, Marios K; de Lemos, James A; Ayers, Colby; Wang, Biqi; Björkbacka, Harry; Pana, Tiberiu A; Thorand, Barbara; Sun, Caroline; Fani, Lana; Malik, Rainer; Dupuis, Josée; Engström, Gunnar; Orho-Melander, Marju; Melander, Olle; Boekholdt, S Matthijs; Zierer, Astrid; Elhadad, Mohamed A; Koenig, Wolfgang; Herder, Christian; Hoogeveen, Ron C; Kavousi, Maryam; Ballantyne, Christie M; Peters, Annette; Myint, Phyo K; Nilsson, Jan; Benjamin, Emelia J; Dichgans, Martin
- Titel:
- Association of Circulating Monocyte Chemoattractant Protein-1 Levels With Cardiovascular Mortality: A Meta-analysis of Population-Based Studies.
- Abstract:
- Importance: Human genetics and studies in experimental models support a key role of monocyte-chemoattractant protein-1 (MCP-1) in atherosclerosis. Yet, the associations of circulating MCP-1 levels with risk of coronary heart disease and cardiovascular death in the general population remain largely unexplored. Objective: To explore whether circulating levels of MCP-1 are associated with risk of incident coronary heart disease, myocardial infarction, and cardiovascular mortality in the general population. Data Sources and Selection: Population-based cohort studies, identified through a systematic review, that have examined associations of circulating MCP-1 levels with cardiovascular end points. Data Extraction and Synthesis: Using a prespecified harmonized analysis plan, study-specific summary data were obtained from Cox regression models after excluding individuals with overt cardiovascular disease at baseline. Derived hazard ratios (HRs) were synthesized using random-effects meta-analyses. Main Outcomes and Measures: Incident coronary heart disease (myocardial infarction, coronary revascularization, and unstable angina), nonfatal myocardial infarction, and cardiovascular death (from cardiac or cerebrovascular causes). Results: The meta-analysis included 7 cohort studies involving 21 401 individuals (mean [SD] age, 53.7 [10.2] years; 10 012 men [46.8%]). Mean (SD) follow-up was 15.3 (4.5) years (326 392 person-years at risk). In models adjusting for age, sex, and race/ethnicity, higher MCP-1 levels at baseline were associated with increased risk of coronary heart disease (HR per 1-SD increment in MCP-1 levels: 1.06 [95% CI, 1.01-1.11]; P = .01), nonfatal myocardial infarction (HR, 1.07 [95% CI, 1.01-1.13]; P = .02), and cardiovascular death (HR, 1.12 [95% CI, 1.05-1.20]; P < .001). In analyses comparing MCP-1 quartiles, these associations followed dose-response patterns. After additionally adjusting for vascular risk factors, the risk estimates were attenuated, but the associations of MCP-1 levels with cardiovascular death remained statistically significant, as did the association of MCP-1 levels in the upper quartile with coronary heart disease. There was no significant heterogeneity; the results did not change in sensitivity analyses excluding events occurring in the first 5 years after MCP-1 measurement, and the risk estimates were stable after additional adjustments for circulating levels of interleukin-6 and high-sensitivity C-reactive protein. Conclusions and Relevance: Higher circulating MCP-1 levels are associated with higher long-term cardiovascular mortality in community-dwelling individuals free of overt cardiovascular disease. These findings provide further support for a key role of MCP-1-signaling in cardiovascular disease.
- Zeitschriftentitel:
- JAMA Cardiol
- Jahr:
- 2021
- Band / Volume:
- 6
- Heft / Issue:
- 5
- Seitenangaben Beitrag:
- 587-592
- Volltext / DOI:
- doi:10.1001/jamacardio.2020.5392
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/33146689
- Print-ISSN:
- 2380-6583
- TUM Einrichtung:
- 273; 656; 657; Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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