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Int J Cardiol. 2018 Apr 15;257:24-29. doi: 10.1016/j.ijcard.2018.01.055. Epub 2018 Feb 1.

Prognostic impact of Interleukin-1 receptor antagonist in patients with documented coronary artery disease.

Author information

1
Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. Electronic address: n.schofer@uke.de.
2
Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
3
Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany; German Center of Cardiovascular Research (DZHK), partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.
4
Department of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany.
5
Department of Medicine II, GPR Klinikum Ruesselsheim, Ruesselsheim, Germany.
6
Department of Internal Medicine, Federal Armed Forces Hospital Koblenz, Koblenz, Germany.
7
Department of Cardiology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany.

Abstract

BACKGROUND:

IL-1β-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-1β 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 1.93 (95% CI 1.33-2.80), p < 0.001; stable angina: adjusted HR: 1.26 (95% CI 0.92-1.73), p = 0.16).

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.

KEYWORDS:

Coronary artery disease; Inflammation; Interleukin-1 receptor antagonist

PMID:
29395365
DOI:
10.1016/j.ijcard.2018.01.055
[Indexed for MEDLINE]

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