Key result
Extreme CXCL5 levels linked to up to ~65% higher mortality in suspected coronary chest pain.
Why the study?
Previous studies on CXCL5 in atherogenesis are conflicting, and outcome data following acute coronary syndrome are scarce.
Does the level of CXCL5 predict all-cause mortality in patients hospitalized for suspected coronary chest pain?
Does the level of CXCL5 predict all-cause mortality in patients hospitalized for suspected coronary chest pain?
CXCL5 exhibits a U-shaped prognostic risk profile, where both low and high levels are associated with increased long-term mortality in patients with suspected coronary chest pain.
Requires caution against linear CXCL5 interpretation for prognosis in suspected coronary chest pain; leaves open its optimal risk model integration.
CXCL5 is a platelet-derived chemokine which promotes inflammatory responses in neutrophils and monocytes through CXCR2. Previous studies on CXCL5 in atherogenesis are to some degree conflicting, with scarce outcome data following acute coronary syndrome. This study aimed to assess the utility and risk profile of CXCL5 as a prognostic marker of all-cause mortality at 5-year follow-up in patients hospitalized for chest pain of suspected coronary origin. We measured CXCL5 levels in platelet-poor plasma in 826 consecutive patients included in the “Risk Markers in the Acute Coronary Syndrome” (RACS) study (ClinicalTrials.gov Identifier: NCT00521976). Stepwise Cox regression models, applying quintiles, were fitted for the biomarker with all-cause mortality within 5 years as the dependent variable. At 5-year follow-up, 250 (30.3%) of the population had died; 34.5% in Quintile (Qt)-1, 32.1% in Qt-2, 23.5% in Qt-3, 29.1% in Qt-4, and 32.1% in Qt-5. Using Qt-3 as a reference, both the univariate and multivariable analysis showed a U-shaped association between CXCL5 and all-cause mortality. Univariate analysis: Qt-1 vs. Qt-3: HR 1.59 (95% CI 1.06–2.39), p = 0.026, and Qt-5 vs. Qt-3: HR 1.44 (0.95–2.18), p = 0.082, respectively. Multivariable analysis: Qt-1 vs. Qt-3: HR 1.65 (1.09–2.48), p = 0.017, and Qt-5 vs. Qt-3: HR 1.52 (1.00–2.30), p = 0.049, respectively. The U-shaped relationship was statistically strengthened, employing a composite endpoint consisting of all-cause mortality, MI or stroke. Our findings suggest that both too-low and too-high levels of CXCL5 may be harmful in patients admitted to hospital with chest pain of suspected coronary origin.
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Nilsen et al. (2026) studied this question. CXCL5 levels showed a U-shaped association with 5-year mortality in patients with suspected coronary chest pain, with the lowest (HR 1.65) and highest (HR 1.52) quintiles having increased risk.
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