Key result
IL-6 is more consistently associated with coronary atherosclerosis presence and burden, whereas hs-CRP is more robustly validated for prognostic risk stratification in chronic coronary syndromes.
Why the study?
Inflammation contributes to plaque progression and adverse events in chronic coronary syndromes, and interleukin-6 and high-sensitivity C-reactive protein are linked but non-equivalent biomarkers requiring synthesis of their biological rationale and clinical evidence for diagnostic and prognostic use.
In chronic coronary syndromes, IL-6 correlates more consistently with coronary atherosclerosis burden while hs-CRP is better validated for prognostic risk stratification, though both should serve only as clinical adjuncts.
Chronic coronary syndromes (CCS) are driven by atherosclerosis in which inflammation contributes to plaque progression and adverse events. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) are linked, non-equivalent bio-markers along the IL-6 → hepatic acute-phase response → CRP axis. This narrative review summarizes the biological rationale and clinical evidence on IL-6 and hs-CRP as diagnostic and prognostic biomarkers in CCS, emphasizing stable cohorts assessed with invasive coronary angiography or coronary CT angiography. Available data suggest IL-6 is more consistently associated with the presence and burden of coronary atherosclerosis, whereas hs-CRP is more robustly validated for prognostic risk stratification but shows heterogeneous associations with anatomic stenosis severity. Both markers are nonspecific and influenced by metabolic comorbidity and background therapy; therefore, they should be interpreted as adjuncts rather than standalone diagnostic tests. Standardized studies with uniform angiographic endpoints are needed to define incremental diagnostic value and clinically relevant thresholds.
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Dragnev et al. (2026) conducted a review in Chronic coronary syndromes (stable angina). Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) was evaluated on Presence and burden of coronary atherosclerosis and prognostic risk stratification. IL-6 is more consistently associated with coronary atherosclerosis presence and burden, whereas hs-CRP is more robustly validated for prognostic risk stratification in chronic coronary syndromes.
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