Levels of soluble tumor necrosis factor receptor 1 and 2, gender, and risk of myocardial infarction in Northern Sweden

• Published in: Atherosclerosis 2018-05, Vol.272, p.41-46
• Main Authors: Carlsson, Axel C., Jansson, Jan-Håkan, Söderberg, Stefan, Ruge, Toralph, Larsson, Anders, Ärnlöv, Johan
• Format: Article
• Language: English
• Subjects: All-cause mortality; Community based cohort; CRP; Cytokines; Epidemiologi; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Health and Welfare; Hälsa och välfärd; Hälsovetenskap; Inflammation; Kardiologi; Klinisk medicin; Medicin och hälsovetenskap; Medicinska och farmaceutiska grundvetenskaper; Oxidative stress; Tumor necrosis factor
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2018.03.020

Soluble receptors for tumor necrosis factor alpha (sTNFR1 and sTNFR2) have been associated with cardiovascular diseases, and some evidence points towards a difference in associated risk between men and women. We aimed to study the association between sTNFR1 and sTNFR2 and incident myocardial infarctions (MI) and to explore the influence of established cardiovascular risk factors in men and women. We conducted a nested case control study in three large Swedish cohorts, including 533 myocardial infarction cases, and 1003 age-, sex- and cohort-matched controls. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. An association between circulating sTNFR1 and sTNFR2 and an increased risk for MI was found when comparing cases and controls. The odds ratios were significant after adjustment for established cardiovascular risk factors and C-reactive protein in women (OR 1.44, 95% CI 1.08–1.93 for TNFR1, and 1.61, 95% CI 1.11–2.34 for TNFR2), but was abolished in men. Women with a combination of elevated CRP and values in the upper quartile of TNFR1 or TNFR2 had a 5-fold higher risk of myocardial infarction versus those with normal CRP and values in the lower three quartiles of TNFR1 or TNFR2. As the risk estimates for TNFR1 and TNFR2 were higher and remained significant after adjustments for established cardiovascular risk factors in women but not in men, a potential role for TNFR1 and TNFR2 in identifying women with a higher MI risk is possible. The future clinical role of TNFR1 and TNFR2 in combination with CRP to identify high risk patients for coronary heart disease has yet to be determined. •We aimed to investigate the association of sTNFR1 and sTNFR2 with incident MI in men and women.•The risk associated with higher levels of TNFR1 and TNFR2 was predominantly found in women.•Additive effects of elevated CRP and TNFR1 and TNFR2, respectively were seen.•We confirm previous studies of a higher risk of coronary heart disease with higher levels of TNFR1 and TNFR2 in women.