BACKGROUND: Increased cytokine and chemokine levels are associated with cardiovascular events in patients with non-ST-elevation acute coronary syndromes (ACS), but the incremental prognostic value of these inflammatory markers is not known. We determined if cytokine and chemokine assessment adds prognostic information to the GRACE Score in patients with ACS. METHODS: Five cytokines (interleukin (IL)-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor (TNF)-alpha soluble receptor I), five chemokines (IL-8, CCL5, CXCL9, CCL2, and CXCL10) and C-reactive protein (CRP) were measured at admission of 87 patients admitted with ACS. RESULTS: During hospitalization, the incidence of cardiovascular events was 13% (7 deaths, 1 nonfatal acute myocardial infarction, and 3 refractory unstable angina). Individuals who developed events had significantly greater levels of CRP, IL-1beta, IL-12, TNF-alpha, IL-8, CXCL9 and CCL2, compared with those free of events. Thus, these markers were used to build an Inflammatory Score, by the input of one point for each of these variables above the 75th percentile. After adjustment for the GRACE Score, the Inflammatory Score independently predicted events (OR=1.80; 95% CI=1.12-1.88). Incorporation of the Inflammatory Score into the GRACE Score promoted a C-statistics improvement from 0.77 (95% CI=0.58-0.96) to 0.85 (95% CI=0.71-1.0). Net reclassification improvement obtained with GRACE-Inflammatory Score was 13% (P=0.007), indicating a significant reclassification. When only CRP was incorporated into GRACE, the increase on C-statistics was not relevant (from 0.77 to 0.80). CONCLUSION: Cytokines and chemokines measured at admission add prognostic information to the GRACE Score in patients admitted with ACS. 2010 Elsevier B.V. All rights reserved.
BACKGROUND: Increased cytokine and chemokine levels are associated with cardiovascular events in patients with non-ST-elevation acute coronary syndromes (ACS), but the incremental prognostic value of these inflammatory markers is not known. We determined if cytokine and chemokine assessment adds prognostic information to the GRACE Score in patients with ACS. METHODS: Five cytokines (interleukin (IL)-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor (TNF)-alpha soluble receptor I), five chemokines (IL-8, CCL5, CXCL9, CCL2, and CXCL10) and C-reactive protein (CRP) were measured at admission of 87 patients admitted with ACS. RESULTS: During hospitalization, the incidence of cardiovascular events was 13% (7 deaths, 1 nonfatal acute myocardial infarction, and 3 refractory unstable angina). Individuals who developed events had significantly greater levels of CRP, IL-1beta, IL-12, TNF-alpha, IL-8, CXCL9 and CCL2, compared with those free of events. Thus, these markers were used to build an Inflammatory Score, by the input of one point for each of these variables above the 75th percentile. After adjustment for the GRACE Score, the Inflammatory Score independently predicted events (OR=1.80; 95% CI=1.12-1.88). Incorporation of the Inflammatory Score into the GRACE Score promoted a C-statistics improvement from 0.77 (95% CI=0.58-0.96) to 0.85 (95% CI=0.71-1.0). Net reclassification improvement obtained with GRACE-Inflammatory Score was 13% (P=0.007), indicating a significant reclassification. When only CRP was incorporated into GRACE, the increase on C-statistics was not relevant (from 0.77 to 0.80). CONCLUSION: Cytokines and chemokines measured at admission add prognostic information to the GRACE Score in patients admitted with ACS. 2010 Elsevier B.V. All rights reserved.
Authors: Nasimudeen R Jabir; Chelapram K Firoz; Mohammad A Kamal; Ghazi A Damanhouri; Mohammed Nabil Alama; Anas S Alzahrani; Hussein A Almehdar; Shams Tabrez Journal: J Clin Lab Anal Date: 2016-11-09 Impact factor: 2.352
Authors: Nicolle Ceneri; Lina Zhao; Bryan D Young; Abigail Healy; Suleyman Coskun; Hema Vasavada; Timur O Yarovinsky; Kenneth Ike; Ruggero Pardi; Lingfen Qin; Li Qin; George Tellides; Karen Hirschi; Judith Meadows; Robert Soufer; Hyung J Chun; Mehran M Sadeghi; Jeffrey R Bender; Alan R Morrison Journal: Arterioscler Thromb Vasc Biol Date: 2016-11-10 Impact factor: 8.311
Authors: Christian Herder; Wouter Peeters; Thomas Illig; Jens Baumert; Dominique P V de Kleijn; Frans L Moll; Ulrike Poschen; Norman Klopp; Martina Müller-Nurasyid; Michael Roden; Michael Preuss; Mahir Karakas; Christa Meisinger; Barbara Thorand; Gerard Pasterkamp; Wolfgang Koenig; Themistocles L Assimes; Panos Deloukas; Jeanette Erdmann; Hilma Holm; Sekar Kathiresan; Inke R König; Ruth McPherson; Muredach P Reilly; Robert Roberts; Nilesh J Samani; Heribert Schunkert; Alexandre F R Stewart Journal: PLoS One Date: 2011-12-06 Impact factor: 3.240