title: Prognostic value of C-reactive protein, fibrinogen, interleukin-6, and macrophage colony stimulating factor in severe unstable angina.
abstract: 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.
authors.affiliation: Department of Cardiology, General Hospital of Nikea, Piraeus, Greece. rallidis@ath.forthnet.gr
authors.forename: Loukianos S
authors.initials: LS
authors.lastname: Rallidis
authors.forename: Maria G
authors.initials: MG
authors.lastname: Zolindaki
authors.forename: Helen S
authors.initials: HS
authors.lastname: Manioudaki
authors.forename: Nikolaos P
authors.initials: NP
authors.lastname: Laoutaris
authors.forename: Aggeliki H
authors.initials: AH
authors.lastname: Velissaridou
authors.forename: Evangelos G
authors.initials: EG
authors.lastname: Papasteriadis
mesh_terms: 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
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016173:Macrophage Colony-Stimulating Factor; D005340:Fibrinogen; D002097:C-Reactive Protein