Inflammatory biomarkers relationship with major adverse cardiovascular events and hypertensive-mediated organ damage, in subjects without established cardiovascular disease

Background: Chronic low-grade inflammation is increasingly recognized as a key determinant of major adverse cardiovascular events (MACE), beyond traditional risk factors. However, the association of inflammatory biomarkers with hypertension-mediated organ damage (HMOD) and long-term MACE in subjects without established CV diseases remains incompletely defined. Methods: We assessed a panel of inflammatory biomarkers, including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-18 (IL-18), osteoprotegerin, calprotectin, and tumor necrosis factor-α (TNF-α), in subjects without established CV diseases. Subclinical HMOD was evaluated at the vascular (pulse wave velocity, carotid intima–media thickness and carotid plaque), cardiac (left ventricular mass and function), and renal (estimated glomerular filtration rate) levels. Participants were prospectively followed for CV events and mortality. Results: Among 804 participants (mean age 51.1 ± 13.0 years; 62.4% men), at multivariable analyses, we found a significant association between MACE and IL-6 (HR 1.519, 95% CI 1.086;2.124, p = 0.015), hs-CRP (1.314, 1.035;1.668, p = 0.025) and calprotectin (4.048, 1.058;15.493, p = 0.041). Furthermore, a positive significant association was found for hs-CRP and calprotectin and carotid plaque and TNF-α and PWV (both continuous and categorical) while a negative association was found between IL-18 and ejection fraction. Conclusions: In subjects without established CV diseases, IL-6, hs-CRP and calprotectin were independently associated with long-term MACE. Furthermore, some association were founded with HMOD suggesting a potential role of inflammation in their pathogenesis.