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Eur Heart J. 2013 Feb;34(8):570-7. doi: 10.1093/eurheartj/ehs263. Epub 2012 Sep 6.

Circulating levels of interleukin-17 and cardiovascular outcomes in patients with acute myocardial infarction.

Author information

1
Department of Clinical Pharmacology, URC-EST, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital St Antoine Paris, University of Pierre et Marie Curie, 27 Rue Chaligny, 75012 Paris, France. tabassome.simon@sat.aphp.fr

Abstract

AIM:

Interleukin (IL)-17 pathway is being clinically targeted in immune-mediated diseases, most of which are associated with a significant cardiovascular risk. We investigated the relationship between serum levels of IL-17 and the risk of cardiovascular events in patients with acute myocardial infarction.

METHODS AND RESULTS:

We used data from 981 patients enrolled in the prospective, multicentre French registry of Acute ST elevation, or non-ST-elevation Myocardial Infarction (Fast-MI, NCT00673036). Serum levels of IL-17 were associated with the risk of all-cause death and recurrent MI at 2 years, with levels of IL-17 below the median indicative of a worse outcome. The impact of IL-17 remained significant after adjustment for known cardiovascular risk factors, C-reactive protein, and treatments including statins: hazard ratio (HR) = 1.40 (1.03-1.91); P = 0.03. IL-17 inhibited mononuclear cell adhesion to endothelium and reduced endothelial vascular cell adhesion molecule (VCAM-1) expression. Patients with low (below the median) IL-17 levels and high (above the median) soluble VCAM-1 (sVCAM-1) levels were at particularly increased risk of death and MI: adjusted HR = 2.22 (1.32-3.75) compared with the high IL-17/low sVCAM-1 group (P = 0.002).

CONCLUSIONS:

Low serum levels of IL-17 are associated with a higher risk of major cardiovascular events in Caucasian patients with acute MI. Our results raise possible concern about the use of inhibitors of the IL-17 pathway in clinical settings associated with a high cardiovascular risk.

CLINICAL TRIALS REGISTRATION:

NCT00673036.

PMID:
22956509
DOI:
10.1093/eurheartj/ehs263
[Indexed for MEDLINE]

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