Interleukin-6 and the Risk of Future Cardiovascular Events in Patients with Angina Pectoris And/Or Healed Myocardial Infarction.
From: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. zfisman@post.tau.ac.il
The American journal of cardiology
- Publish Date: Jul 2006
- ISSN: 0002-9149
- Volume: 98
- Issue: 1
- Pages: 14-8
- Medium: Print
- Language: English
- Citation (JAMA): Fisman Enrique Z, Benderly Michal, Esper Ricardo J, et al. Interleukin-6 and the Risk of Future Cardiovascular Events in Patients with Angina Pectoris And/Or Healed Myocardial Infarction.. Am. J. Cardiol. Jul 2006;98:14-8
Abstract
The aim of this study was to evaluate the prognostic value of interleukin-6 (IL-6) for myocardial infarction (MI) and mortality in a population with stable coronary artery disease (CAD) during a mean period of 6.3 years. IL-6 is a major proinflammatory cytokine of acute phase response; elevated levels are associated with worse prognosis in unstable angina and after acute MI. However, data regarding its long-term prognostic value in stable CAD are limited and controversial. A nested case-control study design was used. Of 3,090 patients with stable CAD, 129 with an adequate blood sample for IL-6 and who reached the end points (MI or sudden death) were randomly selected. Each case was 1:1 matched with 129 controls (alive at the end of the study and free of cardiovascular events) according to age, gender, and treatment. Of the 129 cases, 113 had a MI as the initial event, and for the other 16 the initial event was sudden death. There were 8 patients who first had a MI and later died suddenly. IL-6 was significantly higher in cases (2.34 pg/ml) than in controls (1.65 pg/ml) (p = 0.0004). IL-6 was significantly correlated with C-reactive protein (r = 0.2, p = 0.002); a borderline significance was also found for fibrinogen (r = 0.11, p = 0.07). Each increase of 1 pg/ml in IL-6 was associated with a 1.70 (range 1.23 to 2.45) increased relative odds of subsequent MI or sudden death. Events rate per 1,000 patients-years for the 5 quintiles of IL-6 were 72.26, 89.61, 79.76, 142.53, and 181.08, respectively (p <0.0001). A significantly higher risk in the upper quintile was found (odds ratio, 3.44; 95% confidence interval 1.57 to 8.13). In conclusion, elevated IL-6 levels are strongly associated with future cardiac events and mortality in a population with stable CAD during a long-term follow-up.
Mesh Headings (Keywords): Aged, Angina Pectoris, Blood Glucose, Body Mass Index, Case-Control Studies, Death, Sudden, Cardiac, Female, Fibrinogen, Follow-Up Studies, Humans, Interleukin-6, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Prognosis, Risk Factors, Smoking
Check for Full Text / PubMed Unique Identifier (PMID): 16784912
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