title: Interleukin-6, but not C-reactive protein, predicts the occurrence of cardiovascular events after drug-eluting stent for unstable angina.
abstract: BACKGROUND
  Evidences concerning the predictive value of baseline inflammatory biomarkers after drug-eluting stent (DES) placement are controversial, mainly because the use of statin was not precisely defined.
  
  
  OBJECTIVE
  The aim was to compare the differences between interleukin (IL)-6 and high-sensitivity C-reactive protein (hs-CRP) in predicting cardiovascular events 2 years after stenting in patients with unstable angina (UA) who had not received statin pretreatment.
  
  
  METHODS
  There were 1,896 patients included in this study. The primary end-point was the occurrence of cardiac death or myocardial infarction (MI). Secondary endpoints included all-cause death, stent thrombosis (ST), target lesion revascularization (TLR), target vessel revascularization (TVR), or a composite of major adverse cardiac events (MACE) at 2 years after the procedure.
  
  
  RESULTS
  During the median follow-up of 2.77 years, 96 patients experienced cardiac death (n = 37, 1.95%) or MIs (n = 70, 3.69%), 94 TLRs, 123 TVRs, 215 MACEs, and 21 definite or probable STs. In multivariable Cox proportional-hazards models and discrimination analysis, elevated IL-6 levels were superior to hs-CRP in predicting the occurrence not only of cardiac death or MI (HR 1.337, 95% CI 1.234-1.449, P < 0.001), but also of MACE and late-occurring definite/probable ST. Incorporation of IL-6 into conventional variables resulted in significantly increased c statistic for the prediction of end-points, with the exception of TLR and TVR.
  
  
  CONCLUSIONS
  Elevated IL-6 levels were independent predictors of cardiac death or MI, MACE, and late ST in patients with UA who had not received statin pretreatment, suggesting a role for IL-6 in the inflammatory risk assessment. Pathological studies have confirmed that atherosclerosis is a chronic inflammatory disease. Serum levels of high-sensitivity C-reactive protein (hs-CRP), matrix metalloproteinase, plasminogen activator inhibitor-1, the complement components C3a or C5a, and interleukin(IL)-6 were reported to provide strong and independent indications of the risk for future cardiovascular (CV) events, even among individuals who are thought to be free of vascular disease.
authors.affiliation: Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Gansu Provincial People's Hospital, Lanzhou, China.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Ling
authors.initials: L
authors.lastname: Lin
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Nai-Liang
authors.initials: NL
authors.lastname: Tian
authors.forename: Jun-Xia
authors.initials: JX
authors.lastname: Zhang
authors.forename: Zuo-Ying
authors.initials: ZY
authors.lastname: Hu
authors.forename: Tian
authors.initials: T
authors.lastname: Xu
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Faisal
authors.initials: F
authors.lastname: Latif
authors.forename: Thach
authors.initials: T
authors.lastname: Nguyen
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood*; D003643:Death; D054855:Drug-Eluting Stents; D005260:Female; D005544:Forecasting; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein