Relation between proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome
Relation between proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome
复制标题
DOI：
10.1136/hrt.2005.080382
复制
发表时间：
2006-08-01
期刊：
影响因子：
5.7
通讯作者：
Komsuoglu, B.
中科院分区：
文献类型：
--
作者：
Kilic, T.;Ural, D.;Komsuoglu, B.
目的：探讨非 ST 段抬高型急性冠状动脉综合征 (NSTEACS) 患者血清高敏 (hs) C 反应蛋白 (CRP)、促炎细胞因子浓度、促炎细胞因子与抗炎细胞因子的比值与长期预后之间的关系。设计：入院后前六个月和第一年的前瞻性随访研究。地点：三级转诊中心。患者：80 名患者（60 名男性，20 名女性，平均年龄 60 岁（SD） 10）年）患有 NSTEACS 和中度至高 TIMI（心肌梗塞溶栓）风险评分。 干预措施：在入院时采集 NSTEACS 患者的血样。分析 hs-CRP、(hs) 促炎性细胞因子（白细胞介素 (IL)-1β、IL-6、肿瘤坏死因子 a）和 (hs) 抗炎性 (IL-10) 细胞因子的血清浓度，并通过促炎性细胞因子浓度除以抗炎性细胞因子 IL-10 来计算促炎性与抗炎性细胞因子的比率。 主要结果指标：该研究的主要终点是新冠事件 (NCE)，定义为心源性死亡、非致命性死亡的组合。心肌梗塞和复发性静息心绞痛需要在随访 12 个月内住院。结果：在一年的随访期间，23 名患者（29%）符合 NCE 标准。 NCE 患者的 hs-CRP、IL-1β 和 IL-6 浓度以及 IL-1b: IL-10 和 IL-6: IL-10 比值显着高于无 NCE 患者。在逻辑回归分析中，IL-6：IL-10 比率是 NCE 最重要的预测因子 (p = 0.006)，优势比为 2.24（95% CI 1.26 至 3.97）。结论：细胞因子浓度和促炎细胞因子与抗炎细胞因子比率可能是预测 NSTEACS 患者血管风险的有用标志物。
Objective: To investigate the relation between serum high sensitivity (hs) C reactive protein (CRP), proinflammatory cytokine concentrations, proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome (NSTEACS).Design: Prospective follow-up study for the first six months and then for the first year after admission to hospital.Setting: Tertiary referral centre.Patients: 80 patients (60 men, 20 women, mean age 60 (SD 10) years) with NSTEACS and moderate to high TIMI (Thrombolysis In Myocardial Infarction) risk scores.Interventions: Blood samples from patients with NSTEACS were obtained at the time of admission. Serum concentrations of hs-CRP, (hs) pro-inflammatory (interleukin (IL)-1 beta, IL-6, tumour necrosis factor a) and ( hs) anti-inflammatory (IL-10) cytokines were analysed and proinflammatory to anti-inflammatory cytokine ratios were calculated by dividing proinflammatory cytokine concentrations by anti-inflammatory cytokine IL-10.Main outcome measure: The primary end point of the study was new coronary events (NCE) defined as the combination of cardiac death, non-fatal myocardial infarction and recurrent rest angina that required hospitalisation within 12 months of follow up.Results: During the one-year follow-up period, 23 patients (29%) met the NCE criteria. Concentrations of hs-CRP, IL-1 beta and IL-6 and ratios of IL-1b: IL-10 and IL-6: IL-10 were significantly higher in patients with NCE than in patients without NCE. In the logistic regression analysis, IL- 6: IL- 10 ratio was the most important predictor for NCE (p = 0.006) with an odds ratio of 2.24 (95% CI 1.26 to 3.97).Conclusions: Cytokine concentrations and proinflammatory to anti-inflammatory cytokine ratios may be useful markers for predicting vascular risk in patients with NSTEACS.