In patients post-ACS, the highest quartile of IL-6 was associated with an increased risk of major adverse cardiovascular events compared to the lowest quartile (adj HR 1.43; 95% CI 1.09-1.88).
Cohort (n=4,939)
Is baseline IL-6 concentration associated with adverse cardiovascular outcomes in patients after an acute coronary syndrome?
In patients post-ACS, elevated IL-6 concentration is independently associated with a higher risk of major adverse cardiovascular events and cardiovascular death or heart failure.
Hazard Ratio: 1.43 (95% CI 1.09–1.88)
Background Interleukin‐6 ( IL ‐6) is an inflammatory cytokine implicated in plaque instability in acute coronary syndrome ( ACS ). We aimed to evaluate the prognostic implications of IL ‐6 post‐ ACS . Methods and Results IL ‐6 concentration was assessed at baseline in 4939 subjects in SOLID ‐ TIMI 52 (Stabilization of Plaque Using Darapladib—Thrombolysis in Myocardial Infarction 52), a randomized trial of darapladib in patients ≤30 days from ACS . Patients were followed for a median of 2.5 years for major adverse cardiovascular events; cardiovascular death, myocardial infarction, or stroke) and cardiovascular death or heart failure hospitalization. Primary analyses were adjusted first for baseline characteristics, days from index ACS , ACS type, and randomized treatment arm. For every SD increase in IL ‐6, there was a 10% higher risk of major adverse cardiovascular events (adjusted hazard ratio adj HR 1.10, 95% confidence interval CI 1.01‐1.19) and a 22% higher risk of cardiovascular death or heart failure (adj HR 1.22, 95% CI 1.11‐1.34). Patients in the highest IL ‐6 quartile had a higher risk of major adverse cardiovascular events (adj HR Q4:Q1 1.57, 95% CI 1.22‐2.03) and cardiovascular death or heart failure (adj HR 2.29, 95% CI 1.6‐3.29). After further adjustment for biomarkers (high‐sensitivity C‐reactive protein, lipoprotein‐associated phospholipase A 2 activity, high‐sensitivity troponin I, and B‐type natriuretic peptide), IL ‐6 remained significantly associated with the risk of major adverse cardiovascular events (adj HR Q4:Q1 1.43, 95% CI 1.09‐1.88) and cardiovascular death or heart failure (adj HR 1.79, 95% CI 1.22‐2.63). Conclusions In patients after ACS , IL ‐6 concentration is associated with adverse cardiovascular outcomes independent of established risk predictors and biomarkers. These findings lend support to the concept of IL ‐6 as a potential therapeutic target in patients with unstable ischemic heart disease.
Fanola et al. (Wed,) conducted a cohort in Acute Coronary Syndrome (n=4,939). Interleukin-6 (IL-6) concentration vs. Lowest IL-6 quartile (Q1) was evaluated on major adverse cardiovascular events (cardiovascular death, myocardial infarction, or stroke) (adj HR 1.43, 95% CI 1.09-1.88). In patients post-ACS, the highest quartile of IL-6 was associated with an increased risk of major adverse cardiovascular events compared to the lowest quartile (adj HR 1.43; 95% CI 1.09-1.88).