Interleukin-10 and Acute Coronary Syndromes

Abstract

We have read with interest the article by Cavusoglu et al about the relation of interleukin (IL)-10 and 5-year outcomes in 193 male patients with acute coronary syndromes. In this well-performed study, increased levels of IL-10 on admission were associated independently with increased risk of death and nonfatal myocardial infarction. The authors also reviewed some of the controversial results published in this field, and, because their article provides the ongest follow-up to date, they state that their finding could ip the scales in favor of considering increased IL-10 as a redictor of poorer outcomes in acute coronary syndrome atients. We would like to highlight, however, that other studies upporting both a protective and adverse action of IL-10 in acute coronary syndrome prognosis could be considered in order to unravel the puzzle. In particular, a recent study showed that low levels of IL-10 are associated with adverse events in 1090 non-ST-elevation acute coronary syndrome patients after 4-year follow-up. Several factors may explain the conflicting results found, including patient cohorts, intervention, or sampling time. Remarkably, whereas other authors have included up to 30% of women and only patients with non-ST-elevation acute coronary syndrome, Cavusoglu et al included only male patients and patients with both non-ST-elevation acute coronary syndrome and ST-elevation acute coronary syndrome. Also, Yip et al found that IL-10 on admission was n independent predictor of 30-day mortality in patients ith ST-elevation acute coronary syndrome. These conflictng results may therefore reflect the fact that non-ST-eleation acute coronary syndrome and ST-elevation acute