Clinical utility of circulating interleukin-6 concentrations in the detection of functionally relevant coronary artery disease
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Clinical utility of circulating interleukin-6 concentrations in the detection of functionally relevant coronary artery disease. / Walter, Joan; Tanglay, Yunus; du Fay de Lavallaz, Jeanne; Strebel, Ivo; Boeddinghaus, Jasper; Twerenbold, Raphael; Doerflinger, Stephanie; Puelacher, Christian; Nestelberger, Thomas; Wussler, Desiree; Amrein, Melissa; Badertscher, Patrick; Todd, John; Rentsch, Katharina; Fahrni, Gregor; Jeger, Raban; Kaiser, Christoph; Reichlin, Tobias; Mueller, Christian.
in: INT J CARDIOL, Jahrgang 275, 15.01.2019, S. 20-25.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Clinical utility of circulating interleukin-6 concentrations in the detection of functionally relevant coronary artery disease
AU - Walter, Joan
AU - Tanglay, Yunus
AU - du Fay de Lavallaz, Jeanne
AU - Strebel, Ivo
AU - Boeddinghaus, Jasper
AU - Twerenbold, Raphael
AU - Doerflinger, Stephanie
AU - Puelacher, Christian
AU - Nestelberger, Thomas
AU - Wussler, Desiree
AU - Amrein, Melissa
AU - Badertscher, Patrick
AU - Todd, John
AU - Rentsch, Katharina
AU - Fahrni, Gregor
AU - Jeger, Raban
AU - Kaiser, Christoph
AU - Reichlin, Tobias
AU - Mueller, Christian
N1 - Copyright © 2018 Elsevier B.V. All rights reserved.
PY - 2019/1/15
Y1 - 2019/1/15
N2 - BACKGROUND: Inflammation plays a major role in the pathogenesis of coronary artery disease (CAD).METHODS: We hypothesized, that quantifying inflammation by measuring circulating interleukin-6 concentrations help in the diagnosis and/or prediction of functionally relevant CAD. Among consecutive patients with symptoms suggestive of CAD, functionally relevant CAD was adjudicated in two domains: first, diagnosis according to myocardial perfusion single photon emission tomography (MPI-SPECT) and coronary angiography; second, cardiovascular death and all-cause death during 2-years follow-up. Adjudication was done blinded to the interleukin-6 concentrations.RESULTS: Among 1553 patients, symptoms were adjudicated to be causally related to CAD in 43% (665/1553). Interleukin-6 concentrations were higher in patients with functionally relevant CAD as compared to those without (1.56 pg/mL versus 1.30 pg/mL, p < 0.001), but overall had only low-to-modest diagnostic accuracy (area under the curve [AUC]: 0.57, 95%CI 0.55-0.61) and were no independent predictor of functionally relevant CAD after multivariable adjustment (p = 0.068). Interleukin-6 concentrations had moderate-to-high accuracy in the prediction of cardiovascular death (AUC 0.75, 95%CI 0.69-0.82) and all-cause death (AUC 0.72, 95%CI 0.66-0.78) at 2-years, and remained a significant predictor after multivariable adjustment (p < 0.001). Compared to patients with interleukin-6 concentrations below the median (1.41 pg/mL), patients with concentrations above the median had a significantly higher cumulative incidence of cardiovascular death (1% vs. 4%, log-rank p < 0.001) and all-cause death (2% vs. 8%, log-rank p < 0.001) at 2 years.CONCLUSION: Interleukin-6 concentrations are strong and independent predictors of cardiovascular death and all-cause death.
AB - BACKGROUND: Inflammation plays a major role in the pathogenesis of coronary artery disease (CAD).METHODS: We hypothesized, that quantifying inflammation by measuring circulating interleukin-6 concentrations help in the diagnosis and/or prediction of functionally relevant CAD. Among consecutive patients with symptoms suggestive of CAD, functionally relevant CAD was adjudicated in two domains: first, diagnosis according to myocardial perfusion single photon emission tomography (MPI-SPECT) and coronary angiography; second, cardiovascular death and all-cause death during 2-years follow-up. Adjudication was done blinded to the interleukin-6 concentrations.RESULTS: Among 1553 patients, symptoms were adjudicated to be causally related to CAD in 43% (665/1553). Interleukin-6 concentrations were higher in patients with functionally relevant CAD as compared to those without (1.56 pg/mL versus 1.30 pg/mL, p < 0.001), but overall had only low-to-modest diagnostic accuracy (area under the curve [AUC]: 0.57, 95%CI 0.55-0.61) and were no independent predictor of functionally relevant CAD after multivariable adjustment (p = 0.068). Interleukin-6 concentrations had moderate-to-high accuracy in the prediction of cardiovascular death (AUC 0.75, 95%CI 0.69-0.82) and all-cause death (AUC 0.72, 95%CI 0.66-0.78) at 2-years, and remained a significant predictor after multivariable adjustment (p < 0.001). Compared to patients with interleukin-6 concentrations below the median (1.41 pg/mL), patients with concentrations above the median had a significantly higher cumulative incidence of cardiovascular death (1% vs. 4%, log-rank p < 0.001) and all-cause death (2% vs. 8%, log-rank p < 0.001) at 2 years.CONCLUSION: Interleukin-6 concentrations are strong and independent predictors of cardiovascular death and all-cause death.
KW - Aged
KW - Biomarkers/blood
KW - Cause of Death/trends
KW - Coronary Angiography
KW - Coronary Artery Disease/blood
KW - Early Diagnosis
KW - Exercise Test
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Immunoassay
KW - Interleukin-6/blood
KW - Male
KW - Middle Aged
KW - Multidetector Computed Tomography
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Reproducibility of Results
KW - Survival Rate/trends
KW - Switzerland/epidemiology
KW - Tomography, Emission-Computed, Single-Photon/methods
U2 - 10.1016/j.ijcard.2018.10.029
DO - 10.1016/j.ijcard.2018.10.029
M3 - SCORING: Journal article
C2 - 30340850
VL - 275
SP - 20
EP - 25
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
ER -
