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Comparing inflammatory biomarkers in cardiovascular disease: insights from the LURIC study

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Inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), and interleukin-6 (IL-6), have been associated with an increased risk of future cardiovascular events. While they provide valuable prognostic information, these associations do not necessarily impl...

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Main Authors: Moissl-Blanke, Angela P. (Author) , Delgado Gonzales de Kleber, Graciela (Author) , Scharnagl, Hubert (Author) , Siekmeier, Rüdiger (Author) , Krämer, Bernhard (Author) , Dürschmied, Daniel (Author) , März, Winfried (Author) , Kleber, Marcus E. (Author)
Format: Article (Journal)
Language:English
Published: 29 July 2025
In: International journal of molecular sciences
Year: 2025, Volume: 26, Issue: 15, Pages: 1-15
ISSN:1422-0067
DOI:10.3390/ijms26157335
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/ijms26157335
Verlag, kostenfrei, Volltext: https://www.mdpi.com/1422-0067/26/15/7335
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Author Notes:Angela P. Moissl, Graciela E. Delgado, Hubert Scharnagl, Rüdiger Siekmeier, Bernhard K. Krämer, Daniel Duerschmied, Winfried März and Marcus E. Kleber
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Summary:Inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), and interleukin-6 (IL-6), have been associated with an increased risk of future cardiovascular events. While they provide valuable prognostic information, these associations do not necessarily imply a direct causal role. The combined prognostic utility of these markers, however, remains insufficiently studied. We analysed 3300 well-characterised participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, all of whom underwent coronary angiography. Participants were stratified based on their serum concentrations of hsCRP, SAA, and IL-6. Associations between biomarker combinations and mortality were assessed using multivariate Cox regression and ROC analysis. Individuals with elevated hsCRP and SAA or IL-6 showed higher prevalence rates of coronary artery disease, heart failure, and adverse metabolic traits. These “both high” groups had lower estimated glomerular filtration rate, higher NT-proBNP, and increased HbA1c. Combined elevations of hsCRP and SAA were significantly associated with higher all-cause and cardiovascular mortality in partially adjusted models. However, these associations weakened after adjusting for IL-6. IL-6 alone demonstrated the highest predictive power (AUC: 0.638) and improved risk discrimination when included in multi-marker models. The co-elevation of hsCRP, SAA, and IL-6 identifies a high-risk phenotype characterised by greater cardiometabolic burden and increased mortality. IL-6 may reflect upstream inflammatory activity and could serve as a therapeutic target. Multi-marker inflammatory profiling holds promise for refining cardiovascular risk prediction and advancing personalised prevention strategies.
Item Description:Gesehen am 12.11.2025
Physical Description:Online Resource
ISSN:1422-0067
DOI:10.3390/ijms26157335

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