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

作者：Gloria M. Gager, Benedikt Biesinger, Felix Hofer, Max‐Paul Winter, Christian Hengstenberg, Bernd Jilma, Ceren Eyileten, Marek Postuła, Irene Marthe Lang, Jolanta Maria Siller-Matula · 发表于：Vascular Pharmacology · 年份：2020 · DOI：10.1016/j.vph.2020.106806 · 被引用次数：69 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Cytokine Signaling Pathways and Interactions、Atherosclerosis and Cardiovascular Diseases

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 di...