Association of Circulating Monocyte Chemoattractant Protein–1 Levels With Cardiovascular Mortality
Key result
Higher circulating MCP-1 levels were associated with increased cardiovascular mortality (HR per 1-SD increment 1.12; 95% CI 1.05-1.20; P<0.001) in individuals free of overt cardiovascular disease.
Why the study?
Associations of circulating monocyte-chemoattractant protein-1 (MCP-1) levels with risk of coronary heart disease and cardiovascular death in the general population remained largely unexplored.
Are higher circulating MCP-1 levels associated with increased risk of incident coronary heart disease and cardiovascular mortality in individuals free of overt cardiovascular disease?
Population
21 401 individuals from 7 cohort studies free of overt cardiovascular disease at baseline
Comparison
Circulating MCP-1 levels
Design
Systematic review and random-effects meta-analysis of population-based cohort studies
Follow-up
Mean 15.3 years
Authors
Discussion
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Member takes
Implication
May inform CV risk stratification in primary prevention; extends observational evidence but leaves causality and targeting open.
Key Points
- To determine whether circulating levels of monocyte chemoattractant protein-1 (MCP-1) are associated with risks of incident coronary heart disease, myocardial infarction, and cardiovascular mortality in the general population.
- Conducted a systematic review and harmonized random-effects meta-analysis of 7 population-based cohort studies comprising 21,401 individuals free of overt cardiovascular disease at baseline.
- Followed participants (mean age 53.7 years; 46.8% men) for a mean of 15.3 years (326,392 person-years at risk) using multivariable Cox regression models.
- Each 1-SD increment in baseline MCP-1 levels was associated with higher risks of coronary heart disease (HR, 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).
- Associations exhibited dose-response patterns across quartiles, and the link to cardiovascular death remained significant after adjusting for traditional vascular risk factors, interleukin-6, and high-sensitivity C-reactive protein.
Study Design
Type
Meta-Analysis (n=21,401)
Multicenter
Yes
Structured PICO
Are higher circulating MCP-1 levels associated with increased risk of incident coronary heart disease and cardiovascular mortality in individuals free of overt cardiovascular disease?
P
Population
21,401 community-dwelling individuals free of overt cardiovascular disease at baseline, followed for a mean of 15.3 years.
E
Exposure
Higher circulating monocyte chemoattractant protein-1 (MCP-1) levels
C
Comparator
Lower circulating MCP-1 levels
O
Outcome
Incident coronary heart disease (myocardial infarction, coronary revascularization, and unstable angina), nonfatal myocardial infarction, and cardiovascular death (from cardiac or cerebrovascular causes)hard clinical
Main Result
Hazard Ratio: 1.12 (95% CI 1.05–1.2)
p-value: p=<.001
Higher circulating MCP-1 levels are associated with increased long-term cardiovascular mortality in individuals without baseline cardiovascular disease, supporting its role in atherosclerosis.
Cite This Study
Georgakis et al. (2020) conducted a meta-analysis in Free of overt cardiovascular disease (n=21,401). Circulating monocyte chemoattractant protein-1 (MCP-1) levels vs. Lower MCP-1 levels was evaluated on Cardiovascular death (HR 1.12, 95% CI 1.05-1.20, p=<.001). Higher circulating MCP-1 levels were associated with increased cardiovascular mortality (HR per 1-SD increment 1.12; 95% CI 1.05-1.20; P<0.001) in individuals free of overt cardiovascular disease.