title: Plasma interleukin-10 levels and adverse outcomes in acute coronary syndrome.
abstract: PURPOSE OR BACKGROUND: Interleukin (IL)-10 is an immunoregulatory cytokine that is produced by a variety of cell types, such as macrophages and activated monocytes. IL-10 possesses numerous anti-inflammatory, anti-thrombotic and anti-atherosclerotic properties. Furthermore, patients with acute coronary syndrome have been demonstrated to have reduced levels of IL-10 compared to their stable counterparts. For these reasons, it has been proposed that IL-10 plays a protective role in both atherogenesis and plaque vulnerability. However, 2 short-term studies on the prognostic utility of IL-10 in patients with acute coronary syndrome have provided conflicting results, with one study showing that reduced levels of IL-10 were predictors of adverse outcomes and another showing that elevated levels predicted poor outcomes. The objective of the present study was to investigate the long-term prognostic significance of baseline IL-10 levels in patients with acute coronary syndrome.
  
  
  METHODS
  Baseline plasma IL-10 levels were measured in 193 well-characterized male patients with acute coronary syndrome who were referred for coronary angiography and followed prospectively for 5 years for the development of major adverse cardiovascular events.
  
  
  RESULTS
  After controlling for a variety of baseline variables (including established biomarkers such as high-sensitivity C-reactive protein and N-terminal-pro-B-type natriuretic peptide), plasma IL-10 levels (whether analyzed as a continuous variable or as a categorical variable using receiver operating characteristic-derived cut point) were a strong and independent predictor of the composite outcome of death or non-fatal myocardial infarction when using a Cox proportional hazards model.
  
  
  CONCLUSIONS
  These data demonstrate that, despite biologic plausibility for IL-10 as being a cardioprotective cytokine, elevated baseline plasma levels of IL-10 are a strong and independent predictor of long-term adverse cardiovascular outcomes in patients with acute coronary syndrome.
authors.affiliation: Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, NY, USA. ECavusoglu@aol.com
authors.forename: Erdal
authors.initials: E
authors.lastname: Cavusoglu
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Marmur
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Hojjati
authors.forename: Vineet
authors.initials: V
authors.lastname: Chopra
authors.forename: Mitul
authors.initials: M
authors.lastname: Butala
authors.forename: Rakesh
authors.initials: R
authors.lastname: Subnani
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Huda
authors.forename: Sunitha
authors.initials: S
authors.lastname: Yanamadala
authors.forename: Cyril
authors.initials: C
authors.lastname: Ruwende
authors.forename: Calvin
authors.initials: C
authors.lastname: Eng
authors.forename: David J
authors.initials: DJ
authors.lastname: Pinsky
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D015986:Confounding Factors, Epidemiologic; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009519:New York City / Q000453:epidemiology; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D016753:Interleukin-10; D002097:C-Reactive Protein