IL-6 Linked to Coronary Artery Disease Risk Associated With Elevated Lipoprotein(a)

Elevated lipoprotein(a) [Lp(a)] was associated with a substantially higher risk of developing coronary artery disease (CAD) when accompanied by higher levels of the inflammatory biomarker interleukin-6 (IL-6), highlighting the important role of inflammation in modifying cardiovascular risk. In this UK Biobank study of 43,512 adults without preexisting CAD or aortic valve stenosis (AS), 16% had Lp(a) levels ≥125 nmol/L and were followed for more than 13 years. Among several inflammatory biomarkers evaluated, IL-6 showed the strongest association with both incident CAD and AS. Importantly, IL-6 significantly modified the relationship between elevated Lp(a) and CAD risk: individuals with high Lp(a) and the highest IL-6 levels had a 43% higher risk of CAD, whereas those with high Lp(a) but the lowest IL-6 levels showed little excess risk. Although the neutrophil-to-lymphocyte ratio showed a possible interaction, it did not remain significant after adjustment for multiple testing. No inflammatory biomarker modified the association between Lp(a) and AS risk. These findings identify IL-6 as an inflammatory biomarker that modifies the association between elevated Lp(a) and incident CAD risk and may help improve risk stratification among individuals with high Lp(a) levels. Source: https://jamanetwork.com/