Interleukin-18 as a Predictor of Future Events in Patients With Acute Coronary Syndromes

M. Hartford, O. Wiklund, L. M. Hulten, A. Persson, T. Karlsson, J. Herlitz, J. Hulthe, K. Caidahl
2010 Arteriosclerosis, Thrombosis and Vascular Biology  
Objective-The aim of this study was to assess the short-and long-term prognostic significance of interleukin-18 levels in patients with acute coronary syndromes (ACS). Methods and Results-In patients hospitalized with ACS (median age, 66 years; 30% females), we evaluated associations of serum IL-18 levels from day 1 (nϭ1261) with the short-(Ͻ3 months) and long-term (median, 7.6 years) risk of death, development of congestive heart failure (CHF), and myocardial infarction (MI). IL-18 was not
more » ... . IL-18 was not significantly associated with short-term mortality. In the long term, IL-18 levels were significantly related to all-cause mortality, even after adjustment for clinical confounders (hazard ratio [HR], 1.19; 95% confidence interval, 1.07 to 1.33; Pϭ0.002). Long-term, cardiovascular mortality was univariately related to IL-18, and the adjusted relation between noncardiovascular mortality and IL-18 was highly significant (HR, 1.36; 95% confidence interval, 1.11 to 1.67; Pϭ0.003). IL-18 independently predicted CHF, MI, and cardiovascular death/CHF/MI in both the short and long term. Measurements from day 1 of ACS and 3 months after ACS had a similar power to predict late outcome. Conclusion-The addition of the measurement of IL-18 to clinical variables improved the prediction of risk of all-cause and noncardiovascular mortality. The association between IL-18 and noncardiovascular mortality is intriguing and warrants further study.
doi:10.1161/atvbaha.109.202697 pmid:20689079 fatcat:o5mevnbgtjcaxmjgvbjkumylfu