- 作者：Á ; ngel Ló ; pez-Cuenca<sup>asup> ; Sergio Manzano-Ferná ; ndez<sup>asup><sup> ; sup><sup>bsup><sup> ; sup><sup>sergiosmf13@hotmail.comsup> ; Gregory Y.H. Lip<sup>csup> ; Teresa Casas<sup>dsup> ; Marianela Sá ; nchez-Martí ; nez<sup>asup> ; Alicia Mateo-Martí ; nez<sup>asup> ; Patricio Pé ; rez-Berbel<sup>esup> ; Javier Martí ; nez<sup>esup> ; Diana Herná ; ndez-Romero<sup>asup> ; Ana I. Romero Aniorte<sup>asup> ; Mariano Valdé ; s<sup>asup><sup> ; sup><sup>bsup> ; Francisco Marí ; n<sup>asup><sup> ; sup><sup>bsup>
- 关键词：IL-6 ; interleucina 6 ; PCRus ; proteí ; na C reactiva ultrasensible ; SCASEST ; sí ; ndrome coronario agudo sin elevació ; n del segmento ST
- 刊名：Revista Espa?ola de Cardiolog¡§aa
- 出版年：2013
- 出版时间：March, 2013
- 年：2013
- 卷：66
- 期：3
- 页码：185-192
- 全文大小：316 K
Introduction and objectives
High baseline levels of interleukin-6 and C-reactive protein confer an increased risk of mortality in non-ST-segment elevation acute coronary syndrome. The aim of the study was to determine whether serial measurements of interleukin-6 and high-sensitivity C-reactive protein provide additional information to baseline measurements for risk stratification of non-ST-segment elevation acute coronary syndrome.
Methods
Two hundred and sixteen consecutive patients with non-ST-segment elevation acute coronary syndrome were prospectively included. Blood samples were obtained within 24 h of hospital admission and at 30 days of follow-up. The endpoint was a composite of all-cause death, nonfatal myocardial infarction, or acute decompensated heart failure.
Results
Both interleukin-6 and high-sensitivity C-reactive protein levels decreased from day 1 to day 30, regardless of adverse events (both P<.001). Interleukin-6 levels at 2 time points (interleukin-6 day 1, per pg/mL; hazard ratio=1.006, 95 % confidence interval, 1.002-1.010; P=.002 and interleukin-6 day 30, per pg/mL; hazard ratio=1.047, 95 % confidence interval, 1.021-1.075; P<.001) were independent predictors of adverse events, whereas high-sensitivity C-reactive protein day 1 and high-sensitivity C-reactive protein day 30 levels were not. Patients with interleukin-6 day 1?.24 pg/mL and interleukin-6 day 30?.45 pg/mL had the lowest event rates (4.7 % ), whereas those with both above the median values had the highest event rates (35 % ). After addition of interleukin-6 day 30 to the multivariate model, C-index increased from 0.71 (95 % confidence interval, 0.63-0.78) to 0.80 (95 % confidence interval, 0.72-0.86), P=.042, and net reclassification improvement was 0.39 (95 % confidence interval, 0.14-0.64; P=.002).
Conclusions
In this population, both interleukin-6 and high-sensitivity C-reactive protein concentrations decreased after the acute phase. Serial samples of interleukin-6 concentrations improved the prognostic risk stratification of these patients.
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