All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study

Abstract Background On 13 March 2020, the Danish authorities imposed extensive nationwide lockdown measures to prevent the spread of the coronavirus disease 2019 (COVID-19) and reallocated limited healthcare resources. We investigated mortality rates, overall and according to location, in patients with established cardiovascular disease before, during, and after these lockdown measures. Methods and results Using Danish nationwide registries, we identified a dynamic cohort comprising all Danish citizens with cardiovascular disease (i.e. a history of ischaemic heart disease, ischaemic stroke, heart failure, atrial fibrillation, or peripheral artery disease) alive on 2 January 2019 and 2020. The cohort was followed from 2 January 2019/2020 until death or 16/15 October 2019/2020. The cohort comprised 340 392 and 347 136 patients with cardiovascular disease in 2019 and 2020, respectively. The overall, in-hospital, and out-of-hospital mortality rate in 2020 before lockdown was significantly lower compared with the same period in 2019 [adjusted incidence rate ratio (IRR) 0.91, 95% confidence interval (CI) CI 0.87–0.95; IRR 0.95, 95% CI 0.89–1.02; and IRR 0.87, 95% CI 0.83–0.93, respectively]. The overall mortality rate during and after lockdown was not significantly different compared with the same period in 2019 (IRR 0.99, 95% CI 0.97–1.02). However, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during and after lockdown compared with the same period in 2019 (in-hospital, IRR 0.92, 95% CI 0.88–0.96; out-of-hospital, IRR 1.04, 95% CI1.01–1.08). These trends were consistent irrespective of sex and age. Conclusions Among patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.

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Redefining the Prognostic Value of High-Sensitivity Troponin in COVID-19 Patients: The Importance of Concomitant Coronary Artery Disease

Journal of Clinical Medicine ◽

10.3390/jcm9103263 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3263 ◽

Cited By ~ 2

Author(s):

Marco Schiavone ◽

Alessio Gasperetti ◽

Massimo Mancone ◽

Aaron V. Kaplan ◽

Cecilia Gobbi ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Mortality ◽

Myocardial Injury ◽

High Sensitivity ◽

Cardiovascular Comorbidities ◽

History Of ◽

Coronary Syndromes ◽

Artery Disease ◽

Poor Outcomes ◽

Concomitant Coronary Artery Disease

Background: Although studies assessing cardiovascular comorbidities and myocardial injury in Coronavirus disease 2019 (COVID-19) patients have been published, no reports focused on clinical outcomes of myocardial injury in patients with and without chronic coronary syndromes (CCS) are currently available. Methods: In this study, consecutive COVID-19 patients admitted to four different institutions were screened for enrolment. Patients were divided into two groups (CCS vs. no-CCS). Association with in-hospital mortality and related predictors represented the main study outcome; myocardial injury and its predictors were deemed secondary outcomes. Results: A total of 674 COVID-19 patients were enrolled, 112 (16.6%) with an established history of CCS. Myocardial injury occurred in 43.8% patients with CCS vs. 14.4% patients without CCS, as confirmed by high-sensitivity cardiac troponin (hs-cTn) elevation on admission or during hospitalization. The mortality rate in the CCS cohort was nearly three-fold higher. After adjusting for disease severity, myocardial injury resulted significantly associated with in-hospital mortality in the no-CCS group but not in CCS patients. Conclusions: Patients with CCS and COVID-19 showed high mortality rate. Myocardial injury may be a bystander in CCS patients and COVID-19, while in patients without known history of CCS, myocardial injury has a significant role in predicting poor outcomes.

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Trends in Use of Cardioprotective Medication in Peripheral Artery Disease: A Nationwide Study

Journal of the American Heart Association ◽

10.1161/jaha.120.020333 ◽

2021 ◽

Author(s):

Sadaf Kamil ◽

Thomas S. G. Sehested ◽

Kim Houlind ◽

Jens F. Lassen ◽

Gunnar H. Gislason ◽

...

Keyword(s):

Cardiovascular Disease ◽

Angiotensin Converting Enzyme ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Mortality Rates ◽

Converting Enzyme ◽

Peripheral Artery ◽

Nationwide Study ◽

History Of ◽

Artery Disease

Background Guideline‐based cardioprotective medical therapy is intended to reduce the burden of adverse cardiovascular and limb outcomes in patients with peripheral artery disease (PAD). However, contemporary data describing trends in use of medication remains limited. The present study, therefore, aims to investigate changes in use of cardioprotective medication in PAD. Methods and Results By using Danish national healthcare registries, we identified all patients with first‐time diagnosis of PAD (1997–2016) and classified them into two groups: (1) PAD+ that includes all patients with PAD with a history of cardiovascular disease, ie, myocardial infarction, atrial fibrillation, and stroke (n=162 627); and (2) PAD (n=87 935) that comprise patients without a history of cardiovascular disease. We determined the use of medication in the first 12 months after the incident diagnosis of PAD and estimated age standardized 1‐year mortality rates. Our results showed increase in use of cardioprotective medication throughout the study period in both groups. However, PAD+ had a higher use of medication (acetylsalicylic acid, 3.5%–48.4%; Clopidogrel, 0%–17.6%; vitamin K antagonists, 0.9%–7.8%; new oral anticoagulants, 0.0%–10.1%; Statins, 1.9%–58.1%; angiotensin‐converting enzyme inhibitors, 1.2%–20.6%), compared with PAD (acetylsalicylic acid, 2.9%–54.4%; Clopidogrel, 0%–11.9%; vitamin K antagonists, 0.9%–2.4%; new oral anticoagulants, 0.0%–3.4%; Statins, 1.5%–56.9%; angiotensin‐converting enzyme, 0.9%–17.2%), respectively. Furthermore, 1‐year mortality rates in PAD declined with increased use of medications during study. Conclusions In this nationwide study, use of cardioprotective medication increased considerably with time, but compared to patients with other atherosclerotic diseases, there remains an underuse of guideline‐based medical therapy in patients with PAD.

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Abstract WP226: The Association of Green Tea and Coffee Consumption With Mortality From Cardiovascular Disease and All Causes Among Persons With and Without History of Stroke or Myocardial Infarction: The JACC Study

Stroke ◽

10.1161/str.51.suppl_1.wp226 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Masayuki Teramoto ◽

Isao Muraki ◽

Kokoro Shirai ◽

Akiko Tamakoshi ◽

Hiroyasu Iso

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

General Population ◽

Green Tea ◽

Coffee Consumption ◽

Tea Consumption ◽

Food Frequency ◽

All Cause Mortality ◽

History Of

Background: Both green tea and coffee consumption have been associated with lower risks of mortality from cardiovascular disease (CVD) and all causes in general population, but little is known about those impact on persons with history of CVD. We examined the association of those consumption with these mortalities among persons with and without history of stroke or myocardial infarction in general population. Methods: The study subjects were 60,664 participants (896 stroke and 1751 myocardial infarction survivors and 58,017 persons with no history of stroke or myocardial infarction), aged 40-79 years at the baseline (1988-1990), who completed a lifestyle and medical history questionnaire including self-administered food frequency under the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). Results: During the median follow-up of 18.5 years, a total of 12,745 (7,458 men and 5,287 women) deaths including 3,737 CVD deaths were documented. Green tea and coffee consumption were inversely associated with CVD and all-cause mortality among myocardial infarction survivors as well as persons without history of stroke or myocardial infarction. After adjustment for known cardiovascular risk factors, the lower risks of mortality from CVD and all-causes associated with frequent green tea consumption (5-6 and ≥7 cups/day) or coffee consumption (≥2 cups/day) remained statistical. Conclusions: Both green tea and coffee consumption were inversely associated with risks of CVD and all-cause mortality among myocardial infarction survivors and persons without history of stroke or myocardial infarction.

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Thirteen-Year Trends in Cardiovascular Risk in Men and Women with Chronic Coronary Syndrome

European Heart Journal - Quality of Care and Clinical Outcomes ◽

10.1093/ehjqcco/qcab015 ◽

2021 ◽

Author(s):

Kevin Kris Warnakula Olesen ◽

Esben Skov Jensen ◽

Christine Gyldenkerne ◽

Morten Würtz ◽

Martin Bødtker Mortensen ◽

...

Keyword(s):

Coronary Artery ◽

Incidence Rate ◽

Cardiac Death ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Men And Women ◽

Coronary Syndrome ◽

Adjusted Incidence Rate ◽

Artery Disease ◽

Adjusted Incidence

Abstract Aims To examine combined and sex-specific temporal changes in risks of adverse cardiovascular events and coronary revascularization in patients with chronic coronary syndrome undergoing coronary angiography. Methods We included all patients with stable angina pectoris and coronary artery disease examined by coronary angiography in Western Denmark from 2004 to 2016. Patients were stratified by examination year interval: 2004-2006, 2007-2009, 2010-2012, and 2013-2016. Outcomes were two-year risk of myocardial infarction, ischemic stroke, cardiac death, and all-cause death estimated by adjusted incidence rate ratios using patients examined in 2004-2006 as reference. Results A total of 29,471 patients were included, of whom 70% were men. The two-year risk of myocardial infarction (2.8% versus 1.9%, adjusted incidence rate ratio 0.65, 95% CI 0.53-0.81), ischemic stroke (1.8% versus 1.1%, adjusted incidence rate ratio 0.48, 95% CI 0.37-0.64), cardiac death (2.1% versus 0.9%, adjusted incidence rate ratio 0.38, 95% CI 0.29-0.51), and all-cause death (5.0% versus 3.6%, adjusted incidence rate ratio 0.65, 95% CI 0.55-0.76) decreased from the first examination interval (2004-2006) to the last examination interval (2013-2016). Coronary revascularizations also decreased (percutaneous coronary intervention: 51.6% versus 42.5%; coronary artery bypass grafting: 24.6% versus 17.5%). Risk reductions were observed in both men and women, however, women had a lower absolute risk. Conclusion The risk for adverse cardiovascular events decreased substantially in both men and women with chronic coronary syndrome from 2004 to 2016. These results most likely reflect the cumulative effect of improvements in the management of chronic coronary artery disease.

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Difference in the Mortality Between Weekend and Non-Weekend Coronary Artery Disease Admissions

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0038-1656457 ◽

2017 ◽

Vol 02 (01) ◽

pp. 036-041

Author(s):

M. Sandeep ◽

K. Satish

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Mortality Rate ◽

Hospital Mortality ◽

Risk Score ◽

Wide Spectrum ◽

P Value ◽

Coronary Artery Diseases ◽

Coronary Syndrome ◽

Artery Disease

AbstractBackground: Acute coronary syndrome requires urgent diagnostic and therapeutic procedures, which may not be uniformly available throughout the week. So, we sought to examine the effects of admission on clinical outcomes in patients with wide spectrum coronary artery diseases.Methods: A retrospective analysis of ICCU Inpatient sample database of 17 months from 2015 to 2016 used to compare differences in in-hospital mortality between patients admitted on a non-weekday versus weekend for wide spectrum ACS which include STEMI, NSTEMI and unstable angina and patients with cardiogenic shock. Out of these 75% had higher TIMI risk score (5-7).Results: Total 2700 patients with ACS were included in the present study with wide spectrum coronary artery diseases. Out of that 20 % (n=541) were admitted in weekends and 79.9% (n=2159) were admitted in non-weekends. Total 804 females admitted on non-weekend had a mean age of 61.05±12 years and 162 females admitted on weekend had mean age 58.5±13.3 years (p value=0.025). Out of 2159 admitted on non-weekend, 1355 were males with mean age of 57.65±15.55 years and 379 were males admitted on weekend out of 541 patients with mean age of 56.85±13.1 years (p value =0.314). In-hospital mortality rate of these patients admitted on non-weekends was 9.4% (n=204) and those admitted on weekends was 5.9% (n=32) with statistically significant difference (95% CI; p= 0.003). The mortality rate of ACS without STEMI in non-weekend group was 8.6% (n=170) which was statistically significant (p = 0.006) with mortality of weekend group 5.3% (n=26).Conclusion: Our study shows that there is no added mortality in patients with coronary artery disease on weekend days compared with non-weekend days. As the patients admitted during non-weekend were elder and sicker than the weekend admissions (having the high risk score), the in-hospital mortality is higher on non-weekends. Efforts to improve health care system should ensure comparable outcomes for patients irrespective of time of hospital admission.

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A history of smoking does not reduce long-term benefits of cardiac rehabilitation on cardiorespiratory fitness in men and women with cardiovascular disease

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0349 ◽

2020 ◽

Author(s):

Kenneth Shinkichi Noguchi ◽

Michael Pryzbek ◽

Kevin Moncion ◽

Angelica McQuarrie ◽

Maureen J. MacDonald ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cardiac Rehabilitation ◽

Cardiorespiratory Fitness ◽

Smoking Behaviour ◽

Smoking History ◽

Cardiac Events ◽

Men And Women ◽

All Cause Mortality ◽

History Of

Smoking is an important risk factor for cardiovascular disease and all-cause mortality. Cardiac rehabilitation (CR) is effective for reducing the risk of recurrent cardiac events through improving cardiorespiratory fitness (CRF). Little is known about the influence of smoking on CRF throughout long-term CR. The purpose of this analysis was to compare CRF trajectories among individuals with positive and negative smoking history enrolled in long-term CR. Participants had a positive smoking history if they currently smoke or formerly smoked (Smoke+, n=55, mean age=64.9 ± 9.0 years) and had a negative history if they never smoked (Smoke–, n=34, mean age=61.4 ± 9.0 years). CRF (VO2peak) was measured at baseline and annually thereafter for 6 years. The Smoke+ group had lower CRF compared to the Smoke– group over enrollment (β=-3.29 (SE=1.40), 95% CI -6.04, -0.54, p=0.02), but there was no interaction of smoking history and enrollment (β=0.35 (SE=0.21), 95% CI -0.06, 0.77, p=0.10). Moreover, trajectories were not influenced by pack-years (β=0.01 (SE=0.01), 95% CI -0.01, 0.04, p=0.23) or time smoke-free (β=-0.002 (SE=0.01), 95% CI -0.02, 0.02, p=0.80). Although the trajectories of CRF do not appear to be affected by smoking behaviour, individuals without a history of smoking maintained higher CRF throughout enrollment. Novelty bullets: • The benefits of long-term exercise-based cardiac rehabilitation on cardiorespiratory fitness are similar between those who have smoked and those who have never smoked. • Neither the number of pack-years nor the length of time spent smoke-free influence cardiorespiratory fitness trajectories following long-term cardiac rehabilitation.

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Hyperprolactinemia and the Association with All-Cause Mortality and Cardiovascular Mortality

Hormone and Metabolic Research ◽

10.1055/s-0043-107243 ◽

2017 ◽

Vol 49 (06) ◽

pp. 411-417 ◽

Cited By ~ 5

Author(s):

Jesper Krogh ◽

Christian Selmer ◽

Christian Torp-Pedersen ◽

Gunnar Gislason ◽

Caroline Kistorp

Keyword(s):

Antipsychotic Medication ◽

Cardiovascular Mortality ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

University Hospitals ◽

All Cause Mortality ◽

Adjusted Incidence Rate ◽

Male Patients ◽

Adjusted Incidence

AbstractHyperprolactinemia has been suspected to increase mortality risk, but the available data are conflicting. The objective of this study was to estimate the association between hyperprolactinemia and all-cause and cardiovascular mortality among patients referred for assessment of prolactin. For this study, adults with no prio pituitary disease who underwent prolactin assessment at 3 university Hospitals in Denmark between 2001 and 2011 were included in a retrospective cohort study. A total of 3 633 patients with a median follow-up time of 5.3 years (IQR 2.7–5.7) were included. Mean (SD) age 39.7 (15.5) years and 78% female. 373/3 633 (10.3%) had hyperprolactinemia and during follow-up 330/3 633 (9.1%) patients died of any cause, and 113/3 633 (3.1%) patients died of cardiovascular causes. In males, hyperprolactinemia was associated with age-adjusted incidence rate ratio (IRR) of 1.86 for all-cause mortality (95% CI 1.22–2.82) and 2.55 (95% CI 1.43–4.55) for cardiovascular mortality. The IRR for all-cause mortality was reduced to 1.37 (0.90–2.08) when adjusted for the use of antipsychotic medication. The association between hyperprolactinemia and cardiovascular mortality remained after adjusting for confounders, for example, chronic renal failure, diabetes, and antipsychotic medication. In females, hyperprolactinemia was not associated with all-cause mortality (IRR 1.45; CI 0.86–2.47) or cardiovascular mortality (IRR 0.58; CI 0.14–2.39). In conclusion, hyperprolactinemia was associated with increased cardiovascular mortality in male patients. This association was not found in female patients. Focus on increased cardiovascular risk in males with hyperprolactinemia is warranted.

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Risk stratification by assessment of coronary artery disease using coronary computed tomography angiography in diabetes and non-diabetes patients: a study from the Western Denmark Cardiac Computed Tomography Registry

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez010 ◽

2019 ◽

Vol 20 (11) ◽

pp. 1271-1278 ◽

Cited By ~ 8

Author(s):

Kevin K W Olesen ◽

Anders H Riis ◽

Lene H Nielsen ◽

Flemming H Steffensen ◽

Bjarne L Nørgaard ◽

...

Keyword(s):

Computed Tomography ◽

Incidence Rate ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Cardiac Computed Tomography ◽

Adjusted Incidence Rate ◽

Artery Disease ◽

Event Rates ◽

Adjusted Incidence ◽

Diabetes Patients

Abstract Aims We examined whether severity of coronary artery disease (CAD) measured by coronary computed tomography angiography can be used to predict rates of myocardial infarction (MI) and death in patients with and without diabetes. Methods and results A cohort study of consecutive patients (n = 48 731) registered in the Western Denmark Cardiac Computed Tomography Registry from 2008 to 2016. Patients were stratified by diabetes status and CAD severity (no, non-obstructive, or obstructive). Endpoints were MI and death. Event rates per 1000 person-years, unadjusted and adjusted incidence rate ratios were computed. Median follow-up was 3.6 years. Among non-diabetes patients, MI event rates per 1000 person-years were 1.4 for no CAD, 4.1 for non-obstructive CAD, and 9.1 for obstructive CAD. Among diabetes patients, the corresponding rates were 2.1 for no CAD, 4.8 for non-obstructive CAD, and 12.6 for obstructive CAD. Non-diabetes and diabetes patients without CAD had similar low rates of MI [adjusted incidence rate ratio 1.40, 95% confidence interval (CI): 0.71–2.78]. Among diabetes patients, the adjusted risk of MI increased with severity of CAD (no CAD: reference; non-obstructive CAD: adjusted incidence rate ratio 1.71, 95% CI: 0.79–3.68; obstructive CAD: adjusted incidence rate ratio 4.42, 95% CI: 2.14–9.17). Diabetes patients had higher death rates than non-diabetes patients, irrespective of CAD severity. Conclusion In patients without CAD, diabetes patients have a low risk of MI similar to non-diabetes patients. Further, MI rates increase with CAD severity in both diabetes and non-diabetes patients; with diabetes patients with obstructive CAD having the highest risk of MI.

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Demographic and clinical features associated with in-hospital mortality in Egyptian COVID-19 patients: A retrospective cohort study

10.1101/2021.03.22.21253577 ◽

2021 ◽

Author(s):

Noha Asem ◽

Mohamed Hassany ◽

Khaled Taema ◽

Hossam Masoud ◽

Gehan Elassal ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Mortality ◽

Clinical Laboratory ◽

Strong Association ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Neutrophil Lymphocyte Ratio ◽

Artery Disease ◽

Study Participants ◽

Ct Finding

Introduction: Since the worldwide emergence of the COVID-19, several protocols were used by different healthcare organisations. We evaluated in this study the demographic and clinical characteristics of COVID-19 disease in Egyptian population with special consideration for its mortality predictors. Methodology: 8162 participants (mean age 48.7 years,54.5% males) with RT-PCR positive COVID-19 were included. The electronic medical records were reviewed for demographic, clinical, laboratory, and radiologic features. The primary outcome was the in-hospital mortality rate. Results: The in-hospital mortality was 11.2%. There was a statistically significant strong association of in-hospital mortality with age >60 years old (OR:4.7; 95% CI 4.1-5.4;p<0.001), diabetes mellitus (OR:4.6; 95% CI 3.99-5.32;p<0.001), hypertension (OR:3.9; 95% CI 3.4-4.5;p<0.001), coronary artery disease (OR:2.7; 95% CI 2.2-3.2;p<0.001), chronic obstructive pulmonary disease (OR:2.1; 95% CI 1.7-2.5;p<0.001), chronic kidney disease (OR:4.8; 95% CI 3.9-5.9;p<0.001), malignancy (OR:3.7; 95% CI 2.3-5.75;p<0.001), neutrophil-lymphocyte ratio >3.1 (OR:6.4; 95% CI 4.4-9.5;P< 0.001), and ground glass opacities (GGOs) in CT chest (OR:3.5; 95% CI 2.84-4.4;P<0.001), respectively. There was a statistically significant moderate association of in-hospital mortality with male gender (OR:1.6; 95% CI 1.38-1.83;p<0.001) and smoking (OR:1.6; 95% CI 1.3-1.9;p<0.001). GGOs was reported as the most common CT finding (occurred in 73.1% of the study participants). Conclusions: This multicenter, retrospective study ascertained the higher in-hospital mortality rate in Egyptian COVID-19 patients with different comorbidities.

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Inflammatory markers, clinical and subclinical cardiovascular disease in older persons: the Health ABC study

Circulation ◽

10.1161/circ.103.suppl_1.9998-37 ◽

2001 ◽

Vol 103 (suppl_1) ◽

pp. 1358-1358

Author(s):

Marco Pahor ◽

Steve B Kritchevsky ◽

Russell P Tracy ◽

Anne B Newman ◽

Kim Sutton-Tyrrell ◽

...

Keyword(s):

Cardiovascular Disease ◽

Smoking Status ◽

Ankle Brachial Index ◽

Hdl Cholesterol ◽

Reactive Protein ◽

Body Composition Study ◽

History Of ◽

Subclinical Cardiovascular Disease ◽

Artery Disease ◽

Subclinical Cvd

P37 Inflammation is a potentially important mechanism underlying cardiovascular disease (CVD). Several studies have assessed the asociations of inflammation with clinical CVD, but data on inflammation and sub-clinical CVD are limited. We assessed the association of C-reactive protein (CRP) and interleukin-6 (IL-6) with clinical and subclinical CVD in the Health and Body Composition study (Health ABC), a cohort study of 3075 well functioning older adults living in Memphis, TN, and Pittsburgh, PA. Mean±SDM age was 73.6±2.9 years, 51.5% were women and 41.7% were African American. History of heart attack, heart failure, stroke, peripheral artery disease or CV procedures was reported by 31.4% of participants. Subclinical disease (positive Rose questionnaire for angina or claudication, ECG abnormalities, or ankle brachial index <0.9 in persons with no clinical CVD) was found in 32.4% of participants. CRP (mean 2.31±3.01 μg/ml, range 0.16-54.03 μg/ml) was measured in 1370 participants, and IL-6 (mean±SDM 2.39±1.92 ng/ml, range 0.21-15.96 ng/ml) was measured in 2824 participants. After adjustment for age, gender, race, site, history of diabetes, smoking status, body-mass index, use of anti-inflammatory drugs and serum cholesterol, HDL cholesterol, creatinine and albumin, higher CRP levels were significantly associated with a higher risk of clincal CVD, but not with risk of subclinical CVD (p for trend with increasing IL-6 tertiles =0.0082 and =0.55)(see Table). Higher IL-6 levels were significantly associated with a higher risk of both clinical and sub-clinical CVD (p for trend with increasing IL-6 tertiles <0.0001 and =0.0003). Table 1.

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