title: Interleukin-6 as an independent predictor of future cardiovascular events in high-risk Japanese patients: comparison with C-reactive protein.
abstract: Inflammation is associated with the development of atherosclerotic vascular lesions and some inflammatory parameters are used as cardiovascular (CV) risk markers. The present study was designed to assess the predictive power of interleukin (IL)-6 for future CV events. In 121 Japanese patients with multiple CV risk factors and/or disease, serum concentrations of IL-6 and high sensitive C-reactive protein (hs-CRP) were measured. During follow-up periods (mean, 2.9 years) after the baseline assessment, 50 patients newly experienced CV events such as stroke/transient ischemic attack (n=10), heart failure hospitalization (n=6), acute coronary syndrome (n=7), and revascularization for coronary artery disease (n=15) and peripheral arterial disease (n=12). The serum level of IL-6, but not hs-CRP, was significantly higher in patients who had CV events than in event-free subjects (3.9±2.6 and 3.0±2.2 pg/mL, P=0.04). When the patients were divided into three groups by tertiles of basal levels of IL-6 (<1.85, 1.85-3.77, and ≥3.77 pg/mL), cumulative event-free rates by the Kaplan-Meier method were decreased according to the increase in basal IL-6 levels (65%, 50%, and 19% in the lowest, middle, and highest tertiles of IL-6, respectively; log-rank test, P=0.002). By univariate Cox regression analysis, previous CV disease, creatinine clearance, and serum IL-6 levels were significantly associated with CV events during follow-up. Among these possible predictors, the highest tertile of IL-6 was only an independent determinant for the morbidity in the multivariate analysis (hazard ratio 2.80 vs. lowest tertile, P=0.006). These findings indicate that IL-6 is a powerful independent predictor of future CV events in high-risk Japanese patients, suggesting its predictive value is superior to that of hs-CRP.
authors.affiliation: Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Nishida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Horio
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Iwashima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tokudome
authors.forename: Fumiki
authors.initials: F
authors.lastname: Yoshihara
authors.forename: Satoko
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007564:Japan; D053208:Kaplan-Meier Estimate; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D015850:Interleukin-6; D008055:Lipids; D002097:C-Reactive Protein