PMID- 17932131
OWN - NLM
STAT- MEDLINE
DCOM- 20080310
LR  - 20190722
IS  - 0009-9147 (Print)
IS  - 0009-9147 (Linking)
VI  - 53
IP  - 12
DP  - 2007 Dec
TI  - Risk stratification for heart failure and death in an acute coronary syndrome 
      population using inflammatory cytokines and N-terminal pro-brain natriuretic 
      peptide.
PG  - 2112-8
AB  - BACKGROUND: Inflammation in acute coronary syndrome (ACS) can identify those at 
      greater long-term risks for heart failure (HF) and death. The present study 
      assessed the performance of interleukin (IL)-6, IL-8, and monocyte 
      chemoattractant protein-1 (MCP-1) (cytokines involved in the activation and 
      recruitment of leukocytes) in addition to known biomarkers [e.g., N-terminal 
      pro-brain natriuretic peptide (NT-proBNP)] for predicting HF and death in an ACS 
      population. METHODS: In a cohort of 216 ACS patients, NT-proBNP (Elecsys; Roche) 
      and IL-6, IL-8, and MCP-1 (evidence investigator; Randox) were measured in serial 
      specimens collected early after symptom onset (n = 723). We collected at least 2 
      specimens from each participant: an early specimen (median 2 h; interquartile 
      range 2-4 h) and a later specimen (9 h; 9-9 h), and used the later specimens' 
      biomarker concentrations for risk stratification. RESULTS: An increase in both 
      IL-6 and NT-proBNP was observed but not for IL-8 or MCP-1 early after pain onset. 
      Kaplan-Meier analysis demonstrated that individuals with increased NT-proBNP 
      (>183 ng/L) or cytokines (IL-6 > 6.4 ng/L; above upper limit of normal for IL-8 
      or MCP-1) had a greater probability of death or HF in the following 8 years (P 
      <0.05). In a Cox proportional hazard model adjusted for both CRP and troponin I, 
      increased IL-6, MCP-1, and NT-proBNP remained significant risk factors. Combining 
      all 3 biomarkers resulted in a higher likelihood ratio for death or HF than 
      models restricted to any 2 of these biomarkers. CONCLUSION: IL-6, MCP-1, and 
      NT-proBNP are independent predictors of long-term risk of death or HF, 
      highlighting the importance of identifying leukocyte activation and recruitment 
      in ACS patients.
FAU - Kavsak, Peter A
AU  - Kavsak PA
AD  - Department of Pathology and Molecular Medicine, McMaster University, Hamilton, 
      Ontario, Canada. kavsakp@mcmaster.ca
FAU - Ko, Dennis T
AU  - Ko DT
FAU - Newman, Alice M
AU  - Newman AM
FAU - Palomaki, Glenn E
AU  - Palomaki GE
FAU - Lustig, Viliam
AU  - Lustig V
FAU - MacRae, Andrew R
AU  - MacRae AR
FAU - Jaffe, Allan S
AU  - Jaffe AS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20071011
PL  - England
TA  - Clin Chem
JT  - Clinical chemistry
JID - 9421549
RN  - 0 (CCL2 protein, human)
RN  - 0 (Chemokine CCL2)
RN  - 0 (Interleukin-6)
RN  - 0 (Interleukin-8)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Acute Coronary Syndrome/*diagnosis/immunology/mortality
MH  - Aged
MH  - Chemokine CCL2/*blood
MH  - Female
MH  - Heart Failure/*diagnosis/immunology/mortality
MH  - Humans
MH  - Inflammation/metabolism
MH  - Interleukin-6/*blood
MH  - Interleukin-8/*blood
MH  - Leukocytes/immunology
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2007/10/13 09:00
MHDA- 2008/03/11 09:00
CRDT- 2007/10/13 09:00
PHST- 2007/10/13 09:00 [pubmed]
PHST- 2008/03/11 09:00 [medline]
PHST- 2007/10/13 09:00 [entrez]
AID - clinchem.2007.090613 [pii]
AID - 10.1373/clinchem.2007.090613 [doi]
PST - ppublish
SO  - Clin Chem. 2007 Dec;53(12):2112-8. doi: 10.1373/clinchem.2007.090613. Epub 2007 
      Oct 11.