Abstract
Objectives. To evaluate whether serum interleukin-6 (IL-6) is associated with increased risk of mortality in coronary artery disease (CAD) patients. Methods. We performed a prospective cohort study of 718 CAD patients from the Guangzhou Cardiovascular Disease Cohort (GCDC) study. Multivariable-adjusted Cox proportional hazards regression analyses were used to examine the association between serum IL-6 with all-cause and cardiovascular mortality. Results. During the 1663 person-years of followup, the cumulative all-cause mortality and cardiovascular mortality were 6.5% (n = 47) and 3.3% (n = 24), respectively. The mean length of followup was 2.32 ± 0.81 years. In the multivariable analyses, a one-SD increment in log-transformed serum IL-6 was positively associated with an increased risk of all-cause and cardiovascular mortality, with hazard ratios (HR) of 2.93 (95% CI, 2.11–4.08) and 2.04 (95% CI, 1.34–3.68) within the patients combined and 2.98 (95% CI, 2.12–4.18) and 3.10 (95% CI, 1.98–4.85) within males, respectively. Patients in the highest serum IL-6 tertile versus the lowest tertile were at higher risk of all-cause and cardiovascular mortality, with HR of 17.12 (95% CI 3.11–71.76) and 8.68 (95% CI, 1.88–37.51), respectively. Conclusions. In hospitalized patients with CAD, serum IL-6 is significantly associated with all-cause and cardiovascular mortality.
Highlights
Inflammatory biomarkers have been shown to be associated with and to predict the onset of cardiovascular events [1,2,3]
Patients with higher serum IL-6 levels were older, more likely to be diabetes mellitus (DM), current smokers, and to be separated, and less likely to be married than patients with low IL-6 levels
Our findings show a clear association between serum IL-6 and all-cause and cardiovascular mortality in existing coronary artery disease (CAD) patients
Summary
Inflammatory biomarkers have been shown to be associated with and to predict the onset of cardiovascular events [1,2,3]. It has been reported that increased levels of inflammatory agents, including IL-6, are associated with acute ischemic conditions and are predictors of recurrent events in patients with CAD [1, 2, 7]. The secretion of IL-6, which is a major determinant of the production of acute-phase proteins, is increased in clinical situations characterised by tissue injury, including infections, malignant neoplasms, ischemic diseases, and trauma [10]. This pathophysiology may explain the elevated risk of mortality associated with increased circulating levels of inflammatory markers
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