C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-α in the prognostic classification of unstable angina pectoris
C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-α in the prognostic classification of unstable angina pectoris
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DOI：
10.3109/07853890109002058
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发表时间：
2001-02-01
影响因子：
4.4
通讯作者：
Pyörälä, K
中科院分区：
文献类型：
--
作者：
Koukkunen, H;Penttilä, K;Pyörälä, K
背景资料。炎症过程在冠心病(CHD)的发病机制和冠心病患者预后中起着重要作用。本研究旨在探讨C-反应蛋白(CRP)、纤维蛋白原、白介素6(IL)-6和肿瘤坏死因子-α(TNF-α)在不稳定型心绞痛(UAP)患者中的预后价值，包括评估其联合效应的因素分析。104名女性；中位年龄68岁)。入院时抽取血液样本进行急性时相蛋白和细胞因子测定。结果：在中位随访时间17个月期间，C反应蛋白和IL-6水平最高的三分位数的冠状动脉死亡率是相应合并的下位数三分位数的6倍，纤维蛋白原和肿瘤坏死因子-α的3.5倍。因子分析产生了两个潜在因素，即包括CRP、纤维蛋白原和IL-6在内的“炎症”因素和包括肌钙蛋白T、肌酸激酶MB质量和肿瘤坏死因子-α在内的“损伤”因素。在COX模型中，这两个因素都是冠状动脉死亡和主要冠状动脉事件(冠状动脉死亡或非致命性心肌梗死)风险的独立预测因素。结论：急性时相蛋白和细胞因子水平的升高，特别是CRP和IL-6，是UAP患者严重冠状动脉事件风险的强烈预测因素。
BACKGROUND. inflammatory process has been found to play an important role in the pathogenesis of coronary heart disease (CHD) and in the prognosis of CHD patients, AIM. The aim of this study was to investigate the prognostic Value of C-reactive protein (CRP), fibrinogen, interleukin (IL)-6 and tumour necrosis factor-alpha (TNF-alpha) in patients with unstable angina pectoris (UAP), including factor analysis to assess their joint effects.METHODS. The study comprised 263 consecutive patients (159 men. 104 women; median age 68 years) with UAP. Blood samples for the acute-phase protein and cytokine determinations were drawn on admission.RESULTS. Coronary mortality during the median follow-up time of 17 months was 6-fold higher in the highest tertile for CRP and IL-6 and 3.5-fold higher in the highest tertile for fibrinogen and TNF-alpha than in the respective combined lower tertiles. Factor analysis produced two underlying factors, ie the 'inflammation' factor, including CRP, fibrinogen and IL-6, and the 'injury' factor, including troponin T, creatine kinase MB mass and TNF-alpha. In Cox models, both of these factors were independent predictors of the risk of coronary death and major coronary events (coronary death or nonfatal myocardial infarction).CONCLUSIONS. Elevated levels of acute-phase proteins and cytokines, particularly CRP and IL-6, are strong predictors of the risk of serious coronary events in patients with UAP.