Knowledge of an inflammatory biomarker of cardiovascular risk leads to biomarker-based decreased risk in pre-diabetic and diabetic patients

Abstract

Objective: Diabetes is a risk equivalent for cardiovascular events. The increase in vascular inflammation with diabetes is believed to be responsible for increased risk of ischemic events in diabetic patients. Our goal was to assess whether knowledge of vascular inflammation alters cardiovascular risk over time, and how knowledge of vascular inflammation changes risk in non-diabetic, pre-diabetic and diabetic patients. Methods: We retrospectively studied >100,000 primary-care patients per annum for 5 years (baseline in 2011 through 2015) with tests including lipoprotein profile, hemoglobin A1C and the vascular-specific inflammation risk marker myeloperoxidase. Results were obtained during the patient’s MD Value In Prevention (MDVIP) annual wellness program physical. Results: We show that rates of patients with elevated myeloperoxidase levels were reduced from 14.4%, 15.2% and 21.3% to 4.0%, 4.0% and 6.7% in non-diabetic, pre-diabetic and diabetic patients, respectively, over the 5-year period. Decreases in vascular inflammation were achieved without decreases in the prevalence of pre-diabetes (hemoglobin A1C 5.7%–6.4%) or diabetes (hemoglobin A1C >6.4%) and were observed in patients below or above guideline low-density lipoprotein targets. Conclusions: These data demonstrate that physicians informed of elevated markers of vascular inflammation can lower vascular inflammation correlating with biomarker-based decreased risk of cardiovascular events.