Prognostic value of C-reactive protein, fibrinogen, interleukin-6, and macrophage colony stimulating factor in severe unstable angina.
BACKGROUND
Inflammatory process plays an important role in the pathogenesis of acute coronary syndromes.


OBJECTIVE
The study was undertaken to evaluate whether admission levels of C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6). and macrophage colony stimulating factor (MCSF) can predict short-term prognosis in patients with unstable angina.


METHODS
C-reactive protein, fibrinogen, IL-6, and MCSF were measured on admission in 141 consecutive patients, aged 59 +/- 10 years, with unstable angina (Braunwald class IIIb). Patients were divided into two groups according to their in-hospital outcome: Group 1 comprised 77 patients with a complicated course (2 died, 15 developed nonfatal myocardial infarction, and 60 had recurrence of angina), and Group 2 comprised 64 patients with an uneventful course.


RESULTS
Admission median levels of CRP (8.8 vs. 3.1 mg/l, p = 0.0002). fibrinogen (392 vs. 340 mg/dl, p = 0.008), IL-6 (8.8 vs. 4.5 pg/ml, p = 0.03), and MCSF (434 vs. 307 pg/ml, p = 0.0001) were higher in Group I than in Group 2. The MCSF levels were an independent risk factor for in-hospital events, with an adjusted odds ratio for eventful in-hospital outcome of 3.3 (95% confidence interval 1-10.9, p = 0.04), and correlated with levels of IL-6 (r(s) = 0.52, p = 0.0001), CRP (r(s) = 0.43, p = 0.0001), and fibrinogen (r(s) = 0.25, p = 0.004).


CONCLUSIONS
These findings suggest that among the studied inflammatory indices only increased admission levels of MCSF are strongly and independently related with adverse short-term prognosis in patients with severe unstable angina.
Rallidis
Loukianos S
LS
Department of Cardiology, General Hospital of Nikea, Piraeus, Greece. rallidis@ath.forthnet.gr
Zolindaki
Maria G
MG
Manioudaki
Helen S
HS
Laoutaris
Nikolaos P
NP
Velissaridou
Aggeliki H
AH
Papasteriadis
Evangelos G
EG
D000789:Angina, Unstable / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003627:Data Interpretation, Statistical; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
D015415:Biomarkers; D015850:Interleukin-6; D016173:Macrophage Colony-Stimulating Factor; D005340:Fibrinogen; D002097:C-Reactive Protein