학술논문

Risk stratification for heart failure and death in an acute coronary syndrome population using inflammatory cytokines and N-terminal pro-brain natriuretic peptide
Document Type
Report
Source
Clinical Chemistry. Dec, 2007, Vol. 53 Issue 12, p2112, 7 p.
Subject
Coronary heart disease -- Risk factors
Inflammation -- Risk factors
Atherosclerosis -- Risk factors
Cytokines
Geology, Stratigraphic
Endothelial growth factors
C-reactive protein
Fibrin
Medical research
Medicine, Experimental
Natriuretic peptides
Natural history
Creatine kinase
Fibrinogen
Cardiac patients
Anticoagulants (Medicine)
Language
English
ISSN
0009-9147
Abstract
Background: Inflammation in acute coronary syndrome (ACS) can identify those at greater long-term risks for heart failure (HO and death. The present study assessed the performance of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1) (cytokines involved in the activation and recruitment of leukocytes) in addition to known biomarkers [e.g., N-terminal pro-brain natriuretic peptide (NT-proBNP)] for predicting HF and death in an ACS population. Methods: In a cohort of 216 ACS patients, NT-proBNP (Elecsys[R]; Roche) and IL-6, IL-8, and MCP-1 (evidence investigator[TM]; Randox) were measured in serial specimens collected early after symptom onset (n = 723). We collected at least 2 specimens from each participant: an early specimen (median 2 h; interquartile range 2-4 h) and a later specimen (9 h; 9-9 h), and used the later specimens' biomarker concentrations for risk stratification. Results: An increase in both IL-6 and NT-proBNP was observed but not for IL-8 or MCP-1 early after pain onset. Kaplan-Meier analysis demonstrated that individuals with increased NT-proBNP (>183 ng/L) or cytokines (IL-6 > 6.4 ng/L; above upper limit of normal for IL-8 or MCP-1) had a greater probability of death or HF in the following 8 years (P Conclusion: IL-6, MCP-1, and NT-proBNP are independent predictors of long-term risk of death or HF, highlighting the importance of identifying leukocyte activation and recruitment in ACS patients.
Even modestly increased concentrations of C-reactive protein (CRP), [7] a marker of inflammation, have been shown to be predictive for both short- and long-term risk of heart failure (HF) and [...]