Niklas Schofer1, Sebastian Ludwig2, Nicole Rübsamen2, Renate Schnabel3, Karl J Lackner4, Hans J Ruprecht5, Christoph Bickel6, Ulf Landmesser7, Stefan Blankenberg3, Tanja Zeller3. 1. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. Electronic address: n.schofer@uke.de. 2. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. 3. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany; German Center of Cardiovascular Research (DZHK), partner site Hamburg/Lübeck/Kiel, Hamburg, Germany. 4. Department of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany. 5. Department of Medicine II, GPR Klinikum Ruesselsheim, Ruesselsheim, Germany. 6. Department of Internal Medicine, Federal Armed Forces Hospital Koblenz, Koblenz, Germany. 7. Department of Cardiology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany.
Abstract
BACKGROUND: IL-1β-mediated inflammation contributes to development and progression of coronary artery disease (CAD). We aimed to assess the prognostic impact of the inflammatory marker Interleukin-1 receptor antagonist (IL1-Ra), reflecting high IL-1β activity, in patients with documented CAD. METHODS: IL-1Ra levels were determined in 1337 subjects of the AtheroGene study, a prospective cardiovascular registry comprising patients with CAD as detected by coronary angiography presenting with acute coronary syndrome (ACS) or stable angina. Median follow-up was 6.4 years. RESULTS: Patients with IL1-Ra levels in the highest tertile presented more often with ACS (55% vs. 40% vs. 34%, p < 0.001), were more commonly treated with PCI (47% vs. 39% vs. 34%, p < 0.001), had lower left ventricular ejection fraction (LVEF) (61 ± 15% vs. 62 ± 15% vs. 65 ± 14%, p = 0.001) and higher hs-CRP levels (10.0 vs. 4.2 vs. 2.5 mg/L, p < 0.001). IL1-Ra levels at baseline were predictive for all-cause mortality in the total study cohort after adjustment for conventional cardiovascular risk factors, LVEF, hs-CRP and Troponin T (adjusted HR 1.45 (95% CI 1.16-1.82), p < 0.001). In a subgroup of patients with ACS, but not in those with stable angina, IL1-Ra was an independent predictor for cardiovascular mortality (ACS: adjusted HR 1.93 (95% CI 1.33-2.80), p < 0.001; stable angina: adjusted HR: 1.26 (95% CI 0.92-1.73), p = 0.16). CONCLUSION: IL1-Ra is an independent predictor for adverse outcome in patients with documented CAD, beyond the prognostic value of hs-CRP and Troponin T in particular in the setting of ACS. For CAD patients our finding might improve both, risk assessment in secondary prevention and patient selection for anti-inflammatory treatment.
BACKGROUND: IL-1β-mediated inflammation contributes to development and progression of coronary artery disease (CAD). We aimed to assess the prognostic impact of the inflammatory marker Interleukin-1 receptor antagonist (IL1-Ra), reflecting high IL-1β activity, in patients with documented CAD. METHODS:IL-1Ra levels were determined in 1337 subjects of the AtheroGene study, a prospective cardiovascular registry comprising patients with CAD as detected by coronary angiography presenting with acute coronary syndrome (ACS) or stable angina. Median follow-up was 6.4 years. RESULTS:Patients with IL1-Ra levels in the highest tertile presented more often with ACS (55% vs. 40% vs. 34%, p < 0.001), were more commonly treated with PCI (47% vs. 39% vs. 34%, p < 0.001), had lower left ventricular ejection fraction (LVEF) (61 ± 15% vs. 62 ± 15% vs. 65 ± 14%, p = 0.001) and higher hs-CRP levels (10.0 vs. 4.2 vs. 2.5 mg/L, p < 0.001). IL1-Ra levels at baseline were predictive for all-cause mortality in the total study cohort after adjustment for conventional cardiovascular risk factors, LVEF, hs-CRP and Troponin T (adjusted HR 1.45 (95% CI 1.16-1.82), p < 0.001). In a subgroup of patients with ACS, but not in those with stable angina, IL1-Ra was an independent predictor for cardiovascular mortality (ACS: adjusted HR 1.93 (95% CI 1.33-2.80), p < 0.001; stable angina: adjusted HR: 1.26 (95% CI 0.92-1.73), p = 0.16). CONCLUSION:IL1-Ra is an independent predictor for adverse outcome in patients with documented CAD, beyond the prognostic value of hs-CRP and Troponin T in particular in the setting of ACS. For CAD patients our finding might improve both, risk assessment in secondary prevention and patient selection for anti-inflammatory treatment.
Authors: Jeremias Bayon; Amparo Alfonso; Sandra Gegunde; Eva Alonso; Rebeca Alvarino; Melisa Santas-Alvarez; Ana Testa-Fernandez; Ramon Rios-Vazquez; Luis Botana; Carlos Gonzalez-Juanatey Journal: Cardiol Res Date: 2020-08-01
Authors: Antonio Abbate; Stefano Toldo; Carlo Marchetti; Jordana Kron; Benjamin W Van Tassell; Charles A Dinarello Journal: Circ Res Date: 2020-04-23 Impact factor: 17.367