Associations of inflammatory markers with coronary artery calcification: Results from the Multi-Ethnic Study of Atherosclerosis

ObjectiveInflammatory markers predict coronary heart disease (CHD). However, associations with coronary artery calcium (CAC), a marker of subclinical CHD, are not established.MethodsWe examined cross-sectional associations of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen with CAC presence (Agatston score > 0 by computed tomography) in 6783 Multi-Ethnic Study of Atherosclerosis (MESA) participants.ResultsIn all participants, those in the highest, compared to lowest, quartile of CRP had a relative risk (RR, 95% confidence interval) of 1.13 (1.06-1.19; p < 0.01) for CAC in age, sex and ethnicity adjusted models. For highest versus lowest quartiles, relative risks were 1.22 (1.15-1.30; p < 0.01) for IL-6 and 1.18 (1.11-1.24; p < 0.01) for fibrinogen. Adjusting for CHD risk factors (smoking, diabetes, blood pressure, obesity and dyslipidemia) attenuated RRs. RRs for CAC were 1.05 (0.99-1.12; p = 0.63) for CRP, 1.12 (1.06-1.20; p < 0.01) for IL-6 and 1.09 (1.02-1.16; p = 0.01) for fibrinogen in multivariable adjusted models. Results were similar for men and women and across ethnic groups.ConclusionInflammatory markers were weakly associated with CAC presence and burden in MESA. Our data support the hypothesis that inflammatory biomarkers and CAC reflect distinct pathophysiology.