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J Am Coll Cardiol. 2019 Aug 13;74(6):774-782. doi: 10.1016/j.jacc.2019.06.030.

Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes.

Author information

1
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Departments of Molecular Medicine and Surgery and Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
2
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
3
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Research Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
4
Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
5
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway.
6
Health Metrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
7
Research Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; K.G. Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.
8
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), University of Tromsø, Tromsø, Norway. Electronic address: thor.ueland@medisin.uio.no.

Abstract

BACKGROUND:

The chemokines CCL19 and CCL21 are up-regulated in atherosclerotic disease and heart failure, and increased circulating levels are found in unstable versus stable coronary artery disease.

OBJECTIVES:

The purpose of this study was to evaluate the prognostic value of CCL19 and CCL21 in acute coronary syndrome (ACS).

METHODS:

CCL19 and CCL21 levels were analyzed in serum obtained from ACS patients (n = 1,146) on the first morning after hospital admission. Adjustments were made for GRACE (Global Registry of Acute Coronary Events) score, left ventricular ejection fraction, pro-B-type natriuretic peptide, troponin I, and C-reactive protein levels.

RESULTS:

The major findings were: 1) those having fourth quartile levels of CCL21 on admission of ACS had a significantly higher long-term (median 98 months) risk of major adverse cardiovascular events (MACE) and myocardial infarction in fully adjusted multivariable models; 2) high CCL21 levels at admission were also independently associated with MACE and cardiovascular mortality during short-time (3 months) follow-up; and 3) high CCL19 levels at admission were associated with the development of heart failure.

CONCLUSIONS:

CCL21 levels are independently associated with outcome after ACS and should be further investigated as a promising biomarker in these patients.

KEYWORDS:

CCL19; CCL21; acute myocardial infarction; prognosis; survival; unstable angina pectoris

PMID:
31395128
DOI:
10.1016/j.jacc.2019.06.030

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