Interleukin-6 level is a powerful predictor of long-term cardiovascular mortality in patients with acute coronary syndrome

Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved..

BACKGROUND: The interleukin-6 (IL-6) pathway has a crucial role in the pathogenesis of atherosclerosis, the main cause of cardiovascular diseases. We aimed to characterize the predictive value of inflammatory biomarkers on long-term cardiovascular mortality in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

METHODS: This prospective observational study included 322 consecutive patients with ACS undergoing PCI. Blood-derived biomarkers IL-6 and high-sensitivity C-reactive protein (hsCRP) were assessed at the time point of ACS. Patients were followed-up for 6 years. Long-term cardiovascular mortality was our primary endpoint. Adjusted Cox-regression analysis was used for prediction of events.

RESULTS: Elevated IL-6 values (≥3.3 pg/mL) emerged as an independent and the most powerful predictor for cardiovascular mortality: the ROC analysis showed that IL-6 was more accurate for cardiovascular mortality prediction as compared to hsCRP (IL-6: AUC = 0.72; 95%CI: 0.62-0.81; p = 0.009 vs hsCRP: AUC = 0.56; 95%CI: 0.41-0.72; p = 0.445). The positive predictive value of IL-6 for mortality was 9%, the negative predictive value 99%, sensitivity 94% and specificity 48%. The primary endpoint of long-term cardiovascular death occurred more frequently in patients with high vs low IL-6 (9.0% vs 0.5%, p = 0.001). The multivariate Cox regression analysis revealed that patients with high IL-6 (≥3.3 pg/mL) values were at 8.6-fold higher hazard to die than those with low IL-6 (<3.3 pg/mL) levels (adj. hazard ratio [HR] = 8.60, 95%CI: 1.07-69.32; p = 0.043).

CONCLUSION: In the setting of ACS, high IL-6 values are associated with substantial long-term cardiovascular mortality. Further, IL-6 performs as a superior predictor for cardiovascular death as compared to hsCRP.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:135

Enthalten in:

Vascular pharmacology - 135(2020) vom: 06. Dez., Seite 106806

Sprache:

Englisch

Beteiligte Personen:

Gager, Gloria M [VerfasserIn]
Biesinger, Benedikt [VerfasserIn]
Hofer, Felix [VerfasserIn]
Winter, Max-Paul [VerfasserIn]
Hengstenberg, Christian [VerfasserIn]
Jilma, Bernd [VerfasserIn]
Eyileten, Ceren [VerfasserIn]
Postula, Marek [VerfasserIn]
Lang, Irene M [VerfasserIn]
Siller-Matula, Jolanta M [VerfasserIn]

Links:

Volltext

Themen:

9007-41-4
Acute coronary syndrome
Biomarkers
C-Reactive Protein
Cardiovascular mortality
Comparative Study
High-sensitivity C-reactive protein
IL6 protein, human
Inflammation Mediators
Interleukin-6
Journal Article
Long-term
Observational Study
Powerful predictor
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 04.03.2021

Date Revised 04.03.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.vph.2020.106806

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM316056138