Do inflammatory biomarkers add to the discrimination of cardiovascular disease after allowing for social deprivation?
Aims: To assess the additional discriminative value of adding each of five inflammatory biomarkers to the ASSIGN risk score, which includes social deprivation. Methods and results: In this study, 1319 men and women aged 25–64 in the fourth Glasgow MONICA study were followed-up for cardiovascular endpoints. Baseline C-reactive protein, fibrinogen, IL-6, IL-18, and TNF were related to risk of CVD. The discriminative value of adding each to the ASSIGN score was assessed using area under the receiver operating characteristic (AUC) and relative integrated percentage improvement in classification (RIDI). During a median of 10.5 years, 151 CVD events occurred. After adjusting for ASSIGN variables, each inflammatory marker except IL-18 had a significant (P < 0.05) association with CVD risk. The AUC using ASSIGN [0.799 (95% CI 0.790–0.809)] was improved by the inclusion of C-reactive protein and TNF [0.805 (95% CI 0.795–0.815); P < 0.03], but not by other combinations. C-reactive protein and TN
