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. 2017 Sep 6:9:67.
doi: 10.1186/s13098-017-0266-5. eCollection 2017.

Elevated serum interleukin-6 is predictive of coronary artery disease in intermediate risk overweight patients referred for coronary angiography

Marco V Wainstein  1   2   3   4 , Márcio Mossmann  1 , Gustavo N Araujo  1   2   4 , Sandro C Gonçalves  1   2 , Gabriela L Gravina  4 , Marlei Sangalli  4 , Francine Veadrigo  4 , Roselene Matte  2 , Rejane Reich  2 , Fernanda G Costa  2 , Michael Andrades  5 , Antônio Marcos V da Silva  6 , Marcello C Bertoluci  3   4   7
Affiliations

Elevated serum interleukin-6 is predictive of coronary artery disease in intermediate risk overweight patients referred for coronary angiography

Marco V Wainstein et al. Diabetol Metab Syndr. .

Abstract

Background: Interleukin-6 (IL-6) plays a central role in atherosclerosis and inflammation. It may improve risk prediction in patients at intermediate cardiovascular risk.

Objective: To analyze the impact of serum IL-6 in predicting early angiographic coronary artery disease in patients at intermediate cardiovascular risk with chest pain.

Methods: In a cross-sectional study, patients referred for coronary angiography due to suspected coronary artery disease (CAD) were included. Coronary artery disease was defined as the presence of at least 30% stenosis in one or more coronary artery. Severity of CAD was classified by the anatomic burden score. Performance of serum IL-6 assay was compared with ACC/AHA atherosclerotic cardiovascular disease (ASCVD) risk score and hs-CRP through receiver operating characteristic (ROC) curves.

Results: We have included 48 patients with a mean 10-year ASCVD risk of 10.0 ± 6.8%. The prevalence of CAD was 72.9%. The presence of CAD was associated with higher mean levels of IL-6 (p = 0.025). Patients with CAD had significantly more overweight than subjects without CAD. In 27% of patients, IL-6 was >1.0 pg/mL and 100% of these patients had CAD, while only 64% in those with IL-6 <1.0 pg/mL, corresponding to a positive predictive value of 100% (p = 0.015). The area under the receiver operating characteristic (ROC) curve of IL-6, hs-CRP and ASCVD were respectively 0.72, 0.60 and 0.54. Intermediate risk patients with IL-6 >1.0 pg/mL were further reclassified into ASCVD high risk due to the presence of coronary lesions.

Conclusion: In intermediate risk patients referred for coronary angiography, a serum IL-6 level above 1 pg/mL is predictive of significant CAD. IL-6 determination may be useful to reclassify ASCVD intermediate risk patients into higher risk categories.

Keywords: Coronary angiography; Coronary artery disease; Inflammation; Interleukin-6; Risk factors; Risk scores.

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Figures

Fig. 1
Fig. 1
a Distribution interleukin-6 (IL-6) levels (pg/mL) in patients with (CAD) or without (NCAD). Significant coronary artery disease was defined as at least one vessel with more than 30% of stenosis at coronary angiography. Solid lines indicate the mean. b IL-6 levels (pg/mL) in patients according to the score of severity for coronary artery disease. Patients were divided into: NONE (score zero); MILD TO MODERATE (score 1-15); SEVERE (score 6-17). Data are expressed as mean ± standard deviation. Dashed lines indicate the cut-off value used in the study
Fig. 2
Fig. 2
Comparison between ROC curves of interleukin-6 (IL-6), ASCVD score and high-sensitive C-reactive protein (hs-CRP). Data are expresssed as area under the curve (AUC) and 95% confidence interval
See this image and copyright information in PMC

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