title: Inflammatory Cytokines as Risk Factors for Mortality After Acute Cardiac Events.
abstract: BACKGROUND
  Inflammatory markers have been identified as potential indicators of future adverse outcome after acute cardiac events.
  
  
  OBJECTIVE
  This study aimed to analyze baseline inflammatory cytokines levels in patients with acute heart failure (AHF) and/or acute coronary syndrome (ACS) according to survival. The main objective was to identify risk factors for mortality after an episode of AHF and/or ACS.
  
  
  METHODS
  In this prospective longitudinal study 75 patients with the diagnosis of AHF and/or ACS were enrolled. Baseline laboratory and clinical data were retrieved. Serum and urine interleukin-6 (IL-6) and interleukin-18 (IL-18) levels, plasma B-type natriuretic peptide (BNP) and serum cystatin C values were determined. The primary outcome was in-hospital mortality while secondary outcome was six-month mortality.
  
  
  RESULTS
  Median serum and urine IL-6 levels, serum and urine IL-18 levels, as well as median concentrations of plasma BNP and serum cystatin C, were significantly increased in deceased in comparison to surviving AHF and/or ACS patients. Univariate Cox regression analysis identified serum IL-6, serum IL-18, urine IL-6, urine IL-18 as well as serum cystatin C and Acute Physiology and Chronic Health Evaluation (APACHE) II score as risk factors for mortality after an episode of AHF and/or ACS. Multivariate Cox regression analysis revealed that only serum IL-6 is the independent risk factor for mortality after acute cardiac events (HR 61.7, 95% CI 2.1-1851.0; p=0.018).
  
  
  CONCLUSIONS
  Present study demonstrated the strong prognostic value of serum IL-6 in predicting mortality of patients with AHF and/or ACS.
authors.affiliation: Clinical Center University of Sarajevo, Clinic for Nephrology, Sarajevo, Bosnia and Herzegovina.
authors.forename: Aida
authors.initials: A
authors.lastname: Hamzic-Mehmedbasic
mesh_terms: D054058:Acute Coronary Syndrome / Q000378:metabolism* / Q000401:mortality*; D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000378:metabolism* / Q000401:mortality*; D006801:Humans; D020382:Interleukin-18 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D016207:Cytokines; C000589760:IL18 protein, human; C508600:IL6 protein, human; D020382:Interleukin-18; D015850:Interleukin-6; D020097:Natriuretic Peptide, Brain
keywords: acute coronary syndrome; acute heart failure; inflammatory cytokines; interleukin-6; mortality