Key result
High baseline levels of VCAM-1 and IL-17A were independently associated with an increased risk of major adverse cardiac events in patients with STEMI undergoing PCI (VCAM-1 HR 4.533; IL-17A HR 3.127).
Why the study?
Inflammatory cytokines modulate atherogenesis and plaque rupture in STEMI progression, but their potency in estimating MACE risk required comprehensive investigation.
Do high levels of inflammatory cytokines predict major adverse cardiac events in PCI-treated STEMI patients?
Cohort (n=212)
Do high levels of inflammatory cytokines predict major adverse cardiac events in PCI-treated STEMI patients?
Hazard Ratio: 4.533 (95% CI 1.355–15.16)
p-value: p=0.014
High levels of IL-17A and VCAM-1 are independently associated with an increased risk of major adverse cardiac events in STEMI patients treated with primary PCI.
Should not yet alter STEMI post-PCI management; leaves open whether VCAM-1 and IL-17A are actionable prognostic or therapeutic targets.
OBJECTIVE: Inflammatory cytokines modulate atherogenesis and plaque rupture to involve in ST-segment elevation myocardial infarction (STEMI) progression. The present study determined eight inflammatory cytokine levels in 212 percutaneous coronary intervention (PCI)-treated STEMI patients, aiming to comprehensively investigate their potency in estimating major adverse cardiac event (MACE) risk. METHODS: Serum tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17A, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) of 212 PCI-treated STEMI patients and 30 angina pectoris patients were determined using enzyme-linked immunosorbent assay. RESULTS: TNF-α (52.5 (43.9-62.6) pg/ml versus 46.4 (39.0-59.1) pg/ml, p = 0.031), IL-8 (61.6 (49.6-81.7) pg/ml versus 46.7 (32.5-63.1) pg/ml, p = 0.001), IL-17A (57.4 (45.7-77.3) pg/ml versus 43.2 (34.2-64.6) pg/ml, p = 0.001), and VCAM-1 (593.6 (503.4-811.4) ng/ml versus 493.8 (390.3-653.7) ng/ml, p = 0.004) levels were elevated in STEMI patients compared to angina pectoris patients, while IL-1β (p = 0.069), IL-6 (p = 0.110), IL-10 (p = 0.052), and ICAM-1 (p = 0.069) were of no difference. Moreover, both IL-17A high (vs. low) (p = 0.026) and VCAM-1 high (vs. low) (p = 0.012) were linked with increased cumulative MACE rate. The multivariable Cox's analysis exhibited that IL-17A high (vs. low) (p = 0.034) and VCAM-1 high (vs. low) (p = 0.014) were independently associated with increased cumulative MACE risk. Additionally, age, diabetes mellitus, C-reactive protein, multivessel disease, stent length, and stent type were also independent factors for cumulative MACE risk. CONCLUSION: IL-17A and VCAM-1 high level independently correlate with elevated MACE risk in STEMI patients, implying its potency in identifying patients with poor prognoses.
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Zhang et al. (2022) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=212). High levels of VCAM-1 and IL-17A vs. Low levels of VCAM-1 and IL-17A was evaluated on Cumulative major adverse cardiac event (MACE) risk (HR 4.533, 95% CI 1.355-15.160, p=0.014). High baseline levels of VCAM-1 and IL-17A were independently associated with an increased risk of major adverse cardiac events in patients with STEMI undergoing PCI (VCAM-1 HR 4.533; IL-17A HR 3.127).
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