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

Objective: Inflammatory markers predict coronary heart disease (CHD). However, associations with coronary artery calcium (CAC), a marker of subclinical CHD, are not established. Methods: We 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. Results: In 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. Conclusion: Inflammatory markers were weakly associated with CAC presence and burden in MESA. Our data support the hypothesis that inflammatory biomarkers and CAC reflect distinct pathophysiology.