期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 257, 期 -, 页码 24-29出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2018.01.055
关键词
Coronary artery disease; Inflammation; Interleukin-1 receptor antagonist
资金
- grant of the 'Stiftung Rheinland-Pfalz fur Innovation', Ministry of Science and Education Mainz [AZ 15202-386261/545]
- MAIFOR grant of the Johannes Gutenberg-University Mainz, Germany
- Fondation de France [2002004994]
- French Ministry of Research [ACI IMPBIO 032619]
- Institut National de la Sante et de la Recherche Medicale (Programme National de Recherches sur les Maladies Cardiovasculaires) [A04052DS]
- European Union [HEALTH-F2-2011-278913]
- Siemens
- Abbott Diagnostics
- Thermofisher
- German Centre for Cardiovascular Research (DZHK) [81Z1710101]
- European Research Council under the European Union's Horizon research and innovation program [648131]
- German Federal Ministry of Education and Research [BMBF 01ZX1408A]
- Novartis
Background: IL-1 beta-mediated inflammation contributes to development and progression of coronary artery disease (CAD). We aimed to assess the prognostic impact of the inflammatory marker Interleukin-1 receptor antagonist (IL1-Ra), reflecting high IL-1 beta activity, in patients with documented CAD. Methods: IL-1Ra levels were determined in 1337 subjects of the AtheroGene study, a prospective cardiovascular registry comprising patients with CAD as detected by coronary angiography presenting with acute coronary syndrome (ACS) or stable angina. Median follow-up was 6.4 years. Results: Patients with IL1-Ra levels in the highest tertile presented more often with ACS (55% vs. 40% vs. 34%, p < 0.001), were more commonly treated with PCI (47% vs. 39% vs. 34%, p < 0.001), had lower left ventricular ejection fraction (LVEF) (61 +/- 15% vs. 62 +/- 15% vs. 65 +/- 14%, p = 0.001) and higher hs-CRP levels (10.0 vs. 4.2 vs. 2.5 mg/L, p < 0.001). IL1-Ra levels at baseline were predictive for all-cause mortality in the total study cohort after adjustment for conventional cardiovascular risk factors, LVEF, hs-CRP and Troponin T (adjusted HR 1.45 (95% CI 1.16-1.82), p < 0.001). In a subgroup of patients with ACS, but not in those with stable angina, IL1-Ra was an independent predictor for cardiovascular mortality (ACS: adjusted HR 1.85 (95% CI 1.33-2.58), p < 0.001; stable angina: adjusted HR: 1.25 (95% CI 0.95-1.65), p = 0.11). Conclusion: IL1-Ra is an independent predictor for adverse outcome in patients with documented CAD, beyond the prognostic value of hs-CRP and Troponin T in particular in the setting of ACS. For CAD patients our finding might improve both, risk assessment in secondary prevention and patient selection for anti-inflammatory treatment. (C) 2018 Elsevier B.V. All rights reserved.
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