Prognostic value of interleukin-6 during a 3-year follow-up in patients with acute ST-segment elevation myocardial infarction
Prognostic value of interleukin-6 during a 3-year follow-up in patients with acute ST-segment elevation myocardial infarction
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DOI：
10.1007/s00380-008-1128-8
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发表时间：
2009-09-01
影响因子：
1.5
通讯作者：
Fan, Zhenxing
中科院分区：
文献类型：
--
作者：
Tan, Jing;Hua, Qi;Fan, Zhenxing
越来越多的证据表明，炎症在动脉粥样硬化的发病机制中起着重要作用。这一认识刺激了对不同炎症标志物作为心血管风险潜在预测因子的评估。然而，现有的数据有限，而且存在争议。本研究同时检测急性ST段抬高心肌梗死(STEMI)患者血清白细胞介素6(IL-6)、可溶性CD40配体(SCD40L)、金属蛋白酶-9(MMP9)和金属蛋白酶组织抑制因子-1(TIMP-1)水平，并评价其对预后的预测能力。对263例首发STEMI患者进行了前瞻性队列研究，这些患者在症状出现后6小时内入院。采用双抗体夹心酶联免疫吸附试验检测入院时血清IL-6、sCD40L、MMP9、TIMP-1水平。然后对患者进行前瞻性跟踪，观察3年内心血管死亡率的发生。在263名STEMI患者中，有228名患者(86.7%)获得了随访信息；34名患者在3年的随访期内死于心血管原因。卡普兰-迈耶曲线显示，随着IL-6水平的升高，心血管死亡率显著增加(经对数等级检验，x(2)=14.13，P=0.0002)。Logistic回归分析显示，IL-6是心血管死亡的独立预测因子。本研究表明，入院时IL-6水平升高可为STEMI患者的长期危险分层提供有价值的信息。
Accumulating evidence suggests that inflammation plays an essential role in the pathogenesis of atherosclerosis. This recognition has stimulated the evaluation of different inflammatory markers as potential predictors of cardiovascular risk. However, the existing data are limited and controversial. This study was designed to simultaneously measure serum levels of interleukin-6 (IL-6), soluble CD40 ligand (sCD40L), metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with acute ST segment elevation myocardial infarction (STEMI) and to evaluate their ability to predict prognosis. A prospective cohort study was conducted with 263 patients with first STEMI who were admitted to our institute within 6 h of symptoms onset. Clinical data were recorded and serum admission levels of IL-6, sCD40L, MMP-9, and TIMP-1 were measured by sandwich enzyme-linked immunosorbent assay. The patients were then followed prospectively for the occurrence of cardiovascular mortality for 3 years. Follow-up information was available for 228 patients (86.7%) from the 263 STEMI patients; 34 patients died from cardiovascular causes during the 3-year follow-up period. Kaplan-Meier plots demonstrated a significant increase in cardiovascular mortality with increasing IL-6 levels (chi(2) = 14.13, P = 0.0002, by log-rank test). Logistic regression analysis revealed that IL-6 was an independent predictor for cardiovascular mortality. The present study indicates that elevated admission level of IL-6 could provide valuable information for long-term risk stratification in patients with STEMI.