Plasma Interleukin-10 Levels and Adverse Outcomes in Acute Coronary Syndrome

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• 作者：Erdal Cavusoglu MD^a ; ^b ; ^{ECavusoglu@aol.com"" rel=""nofollow} ; Jonathan D. Marmur MD^b ; Mohammad R. Hojjati MD ; PhD^b ; Vineet Chopra MD^a ; Mitul Butala MD^b ; Rakesh Subnani BS^b ; Mohammad S. Huda MD^b ; Sunitha Yanamadala PhD^c ; Cyril Ruwende MD ; PhD^c ; Calvin Eng MD^a ; David J. Pinsky MD^c
• 关键词：Acute coronary syndrome ; Biomarker ; Inflammation ; Interleukin-10 ; Prognosis
• 刊名：The American Journal of Medicine
• 出版年：2011
• 出版时间：August 2011
• 年：2011
• 卷：124
• 期：8
• 页码：724-730
• 全文大小：347 K

文摘

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.