Pulmonary tumour embolism

Background Macrophage inhibitory cytokine-1 (MIC-1) is part of the TGF-β superfamily. Raised concentrations of MIC-1 in serum arise in several disease states, can be detected in normal individuals, and can partly be genetically determined. We aimed to investigate whether MIC-1 has a role in atherothrombosis. Methods We did a prospective, nested, case-control study in 27 628 initially healthy women. Of these women, we established baseline concentrations of MIC-1 in 257 who subsequently had myocardial infarction, stroke, or died from a cardiovascular event (cases) and in 257 matched for age and smoking status, who did not report cardiovascular disease during 4-year follow-up (controls). We also assessed polymorphisms in the MIC-1 gene (MIC-1 H and MIC-1 D) in all 514 women. Findings MIC-1 concentrations were higher at baseline in women who subsequently had cardiovascular events than in those who did not (618 vs 538 pg/mL, p=0•0002). Concentrations above the 90th percentile (>856 pg/mL) were associated with a 2•7-fold increase in risk (95% CI 1•6–4•9, p=0•001). This effect was independent of traditional cardiovascular risk factors and at least additive to that of C-reactive protein. There was no significant association between MIC-1 polymorphism and vascular events. Interpretation MIC-1 could be a novel target for cardiovascular disease prevention