Association of serum cytokines with coronary chronic total occlusion and their role in predicting procedural outcomes

Abstract

BackgroundCytokines are strongly associated with coronary artery disease (CAD); however, few studies have explored the relevance of cytokines in coronary chronic total occlusion (CTO). This study aimed to clarify the association of cytokines with CTO and its procedural outcomes. MethodsA total of 526 patients with suspected CAD but not acute myocardial infarction were enrolled and divided into CTO (n = 122) and non–CTO (n = 404) groups based on coronary angiography. Furthermore, serum levels of 12 cytokines [Interleukin–1β (IL–1β), IL–2, IL–4, IL–5, IL–6, IL–8, IL–10, IL–12p70, IL–17, tumor necrosis factor–α (TNF–α), interferon–α (IFN–α), and IFN–γ] were measured for each patient. ResultsPatients with CTO had higher rates of male (P = 0.001), smoking (P = 0.014), and diabetes (P = 0.008); higher levels of IL–6 (P < 0.001), total triglycerides (P = 0.020), serum creatine (P = 0.001), and high–sensitivity troponin I (P = 0.001); and lower IL–4 (P < 0.001), total cholesterol (P = 0.027), and high–density lipoprotein cholesterol (HDL–C) (P < 0.001) levels compared to those without CTO. IL–4 (OR = 0.216, 95%CI:0.135–0.345, P < 0.001), IL–6 (OR = 1.248, 95%CI:1.165–1.337, P < 0.001), and HDL–C (OR = 0.047, 95%CI:0.010–0.221, P < 0.001) were identified as independent predictors of CTO. And good predictive performance (AUC = 0.876) for CTO, with a sensitivity of 81.96% and specificity of 81.19%, could be achieved by combining these three predictors. Furthermore, patients with procedural success had younger age (P = 0.004) and lower serum IL-6 levels (P = 0.039) compared to those with procedural failure, and IL-6 levels (OR = 0.962, 95%CI: 0.931-0.995, P = 0.023) were associated with procedural success. ConclusionIL–4, IL–6, and HDL–C levels were strongly associated with CTO, and IL–6 also linked to procedural outcomes of CTO.