beta-carotene and Death--Sudden--Cardiac

Sudden cardiac death (SCD) is an important cause of mortality even among apparently healthy populations. However, our ability to identify those at risk for SCD in the general population is poor, and more specific markers are needed.. To compare and contrast the relative importance of C-reactive protein (CRP), homocysteine, and lipids as long-term predictors of SCD, we performed a prospective, nested, case-control analysis involving 97 cases of SCD among apparently healthy men enrolled in the Physician's Health Study. Of these plasma markers measured, only baseline CRP levels were significantly associated with the risk of SCD over the ensuing 17 years of follow-up (P for trend=0.001). The increase in risk associated with CRP levels was primarily seen among men in the highest quartile, who were at a 2.78-fold increased risk of SCD (95% CI 1.35 to 5.72) compared with men in the lowest quartile. These results were not significantly altered in analyses that (in addition to the matching variables of age and smoking status) controlled for lipid parameters, homocysteine, and multiple cardiac risk factors (relative risk for highest versus lowest quartile 2.65, 95% CI 0.79 to 8.83; P for trend=0.03). In contrast to the positive relationship observed for CRP, neither homocysteine nor lipid levels were significantly associated with risk of SCD.. These prospective data suggest that CRP levels may be useful in identifying apparently healthy men who are at an increased long-term risk of SCD.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Antioxidants; Aspirin; beta Carotene; Biomarkers; C-Reactive Protein; Case-Control Studies; Death, Sudden, Cardiac; Follow-Up Studies; Homocysteine; Humans; Lipids; Male; Middle Aged; Physicians; Predictive Value of Tests; Prospective Studies; Risk Assessment; Risk Factors

Topics: beta Carotene; Death, Sudden, Cardiac; Humans; Male

To examine whether serum concentrations of carotenoids are related to the risk of sudden cardiac death (SCD) in middle-aged men.. The study population consisted of 1031 Finnish men aged 46-65 years of the Kuopio Ischemic Heart Disease Risk Factor (KIHD) cohort. Serum concentrations of carotenoids were measured by high-performance liquid chromatography. The hazard ratios (HR) of serum β-carotene, lycopene and α-carotene were estimated by using the Cox proportional hazard model after adjusting for age and other potential confounding factors.. During a median follow-up of 15.9 years a total of 59 incidents of SCD occurred. After controlling for age, systolic blood pressure, waist circumference, smoking, alcohol consumption, years of education, serum LDL cholesterol, serum hs-CRP, diabetes, prevalent coronary heart disease (CHD) and congestive heart failure (CHF), men in the lowest tertile of serum concentrations of β-carotene had a 2-fold increased risk of SCD (HR=2.15, 95% CI: 1.02-4.51; p=0.044) as compared to those in the highest tertile. The risk of SCD was borderline significant for lycopene. In addition, low serum β-carotene concentrations increased the risk of cardiovascular disease (CVD) and total mortality. Lycopene and α-carotene were not related to the risk of SCD.. Our findings suggest that low serum β-carotene concentrations may increase the risk of SCD in middle-aged Finnish men. Furthermore, low serum β-carotene concentrations may be related to the risk of CVD and total mortality.

Topics: Aged; beta Carotene; Death, Sudden, Cardiac; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Risk Factors