IL-6 and HMGB1 Levels for Predicting Major Adverse Vascular Events after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome
DOI:
https://doi.org/10.59958/hsf.7497Keywords:
acute coronary syndrome, major adverse cardiovascular events, interleukin 6, high-mobility group box 1Abstract
Objective: This study aims to investigate the value of interleukin 6 (IL-6) and high-mobility group box 1 (HMGB1) in predicting major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods: Patients with ACS who were treated in our hospital from October 2022 to October 2023 were divided into MACE and no-MACE groups according to the occurrence of MACE after PCI. The baseline data and IL-6 and HMGB1 levels in the two groups were observed, and the influencing factors of MACE in patients with ACS after PCI were evaluated with a logistic regression test. The receiver operator characteristic curve (ROC) values of IL-6 and HMGB1 in the prediction of MACE after PCI in patients with ACS were calculated. Results: No significant differences in age, sex, body mass index (BMI), and other general data were found between the groups. Compared with the patients in the no-MACE group, the patients in the MACE group had a history of smoking (p = 0.011), hypertension (p < 0.001), diabetes (p < 0.001), more coronary lesions (p = 0.013), longer coronary lesions (p = 0.006), higher preoperative Gensini score (p < 0.001), and lower left ventricular ejection fractions (LVEF) (p < 0.001). The levels of IL-6 and HMGB1 in the MACE group were significantly higher than those in the no-MACE group. Coronary lesion length, Gensini score, LVEF, IL-6, and HMGB1 had good predictive value for MACE after PCI. The area under the curve (AUC) scores were 0.683, 0.941, 0.816, 0.878, and 0.737. The sensitivity was 53.13%, 81.25%, 84.37%, 78.12%, and 53.13%, and the specificity was 87.50%, 93.18%, 63.64%, 86.36%, and 86.36%, respectively. Analysis of IL-6 and HMGB1 levels showed that the AUC was 0.922, the sensitivity was 90.62%, the specificity was 82.95%, and the 95% confidence interval (CI) was (0.858–0.963; p < 0.05). Conclusion: IL-6 and HMGB1 have good predictive value for MACE after PCI for patients with ACS and can be used as clinical evaluation indexes.
References
Shi Z, Zhao C, Hu J, Dai Q, Guan M, Zhong C, et al. The Application of Traditional Chinese Medicine Injection on Patients with Acute Coronary Syndrome during the Perioperative Period of Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine. 2020; 2020: 3834128.
Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. Journal of epidemiology and global health. 2021; 11: 169–177.
Madhavan MV, Stone GW. Adverse events beyond 1 year after percutaneous coronary intervention. Current Opinion in Cardiology. 2020; 35: 687–696.
Wang L, Jin Y. Noncoding RNAs as Biomarkers for Acute Coronary Syndrome. BioMed Research International. 2020; 2020: 3298696.
He W, Zhu L, Huang Y, Zhang Y, Shen W, Fang L, et al. The relationship of MicroRNA-21 and plaque stability in acute coronary syndrome. Medicine. 2019; 98: e18049.
Richards JR, Bing ML, Moulin AK, Elder JW, Rominski RT, Summers PJ, et al. Cannabis use and acute coronary syndrome. Clinical Toxicology. 2019; 57: 831–841.
Ziegler L, Gajulapuri A, Frumento P, Bonomi A, Wallén H, de Faire U, et al. Interleukin 6 trans-signalling and risk of future cardiovascular events. Cardiovascular Research. 2019; 115: 213–221.
Carrero JJ, Andersson Franko M, Obergfell A, Gabrielsen A, Jernberg T. hsCRP Level and the Risk of Death or Recurrent Cardiovascular Events in Patients With Myocardial Infarction: a Healthcare-Based Study. Journal of the American Heart Association. 2019; 8: e012638.
Angeli F, Verdecchia P, Savonitto S, Cavallini S, Santucci A, Coiro S, et al. Soluble CD40 ligand and outcome in patients with coronary artery disease undergoing percutaneous coronary intervention. Clinical Chemistry and Laboratory Medicine. 2021; 60: 118–126.
Rath D, Geisler T, Gawaz M, Vogel S. HMGB1 Expression Level in Circulating Platelets is not Significantly Associated with Outcomes in Symptomatic Coronary Artery Disease. Cellular Physiology and Biochemistry. 2017; 43: 1627–1633.
Task Force Members; Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. [published correction appears in European Heart Journal. 2014; 35: 2260–2261]. European Heart Journal. 2013; 34: 2949–3003.
Wright RS, Anderson JL, Adams CD, Bridges CR, Casey DE, Jr, Ettinger SM, et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/ Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011; 123: 2022–2060.
Qayyum S, Rossington JA, Chelliah R, John J, Davidson BJ, Oliver RM, et al. Prospective cohort study of elderly patients with coronary artery disease: impact of frailty on quality of life and outcome. Open Heart. 2020; 7: e001314.
Andersen BK, Ding D, Mogensen LJH, Tu S, Holm NR, Westra J, et al. Predictive value of post-percutaneous coronary intervention fractional flow reserve: a systematic review and meta-analysis. European Heart Journal. Quality of Care & Clinical Outcomes. 2023; 9: 99–108.
Nardella E, Biscetti F, Rando MM, Cecchini AL, Nicolazzi MA, Rossini E, et al. Development of a biomarker panel for assessing cardiovascular risk in diabetic patients with chronic limb-threatening ischemia (CLTI): a prospective study. Cardiovascular Diabetology. 2023; 22: 136.
Lowe GDO, Rumley A, McMahon AD, Ford I, O'Reilly DSJ, Packard CJ, et al. Interleukin-6, fibrin D-dimer, and coagulation factors VII and XIIa in prediction of coronary heart disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004; 24: 1529–1534.
Li W, Sama AE, Wang H. Role of HMGB1 in cardiovascular diseases. Current Opinion in Pharmacology. 2006; 6: 130–135.
Groenland FTW, Yee J, Mahmoud KD, Nuis RJ, Wilschut JM, Diletti R, et al. Cardiac Catheterizations in Patients With Acute Coronary Syndrome and Prior Coronary Bypass Surgery: Impact of Native vs Graft vs Absent Culprit Lesions on Clinical Outcomes and Treatment Strategy. Cardiovascular Revascularization Medicine: Including Molecular Interventions. 2022; 44: 44–50.
Kondo T, Nakano Y, Adachi S, Murohara T. Effects of Tobacco Smoking on Cardiovascular Disease. Circulation Journal. 2019; 83: 1980–1985.
Ebina T. Smoking and Incident Hypertension - Importance of Cotinine-Verified Smoking Status. Circulation Journal. 2018; 82: 1510–1512.
Turan T, Özderya A, Sahin S, Kul S, Konuş AH, Kara F, et al. Abnormal Circadian Blood Pressure Variation is Associated with SYNTAX Scores in Hospitalized Patients with Acute Coronary Syndrome. Arquivos Brasileiros De Cardiologia. 2022; 119: 76–84.
Sattar N, Lee MMY, Kristensen SL, Branch KRH, Del Prato S, Khurmi NS, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. The Lancet. Diabetes & Endocrinology. 2021; 9: 653–662.
Rastogi A, Sudhayakumar A, Schaper NC, Jude EB. A paradigm shift for cardiovascular outcome evaluation in diabetes: Major adverse cardiovascular events (MACE) to major adverse vascular events (MAVE). Diabetes & Metabolic Syndrome. 2023; 17: 102875.
Hara H, Ono M, Kawashima H, Kogame N, Mack MJ, Holmes DR, et al. Impact of stent length and diameter on 10-year mortality in the SYNTAXES trial. Catheterization and Cardiovascular Interventions. 2021; 98: E379–E387.
Cai Z, Li L, Wang H, Yuan S, Yin D, Song W, et al. Effect of type 2 diabetes on coronary artery ectasia: smaller lesion diameter and shorter lesion length but similar adverse cardiovascular events. Cardiovascular Diabetology. 2022; 21: 9.
Wang KY, Zheng YY, Wu TT, Ma YT, Xie X. Predictive Value of Gensini Score in the Long-Term Outcomes of Patients With Coronary Artery Disease Who Underwent PCI. Frontiers in Cardiovascular Medicine. 2022; 8: 778615.
Zhong J, Chen Q, Chen L, Ye Z, Chen H, Sun J, et al. Physiological benefits evaluated by quantitative flow ratio in patients with reduced left ventricular ejection fraction who underwent percutaneous coronary intervention. BMC Cardiovascular Disorders. 2020; 20: 523.
Wang L, Cong HL, Zhang JX, Hu YC, Wei A, Zhang YY, et al. Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome. Cardiovascular Diabetology. 2020; 19: 80.
Zamani P, Schwartz GG, Olsson AG, Rifai N, Bao W, Libby P, et al. Inflammatory biomarkers, death, and recurrent nonfatal coronary events after an acute coronary syndrome in the MIRACL study. Journal of the American Heart Association. 2013; 2: e003103.
Kaur N, Ruiz-Velasco A, Raja R, Howell G, Miller JM, Abouleisa RRE, et al. Paracrine signal emanating from stressed cardiomyocytes aggravates inflammatory microenvironment in diabetic cardiomyopathy. iScience. 2022; 25: 103973.
Gager GM, Biesinger B, Hofer F, Winter MP, Hengstenberg C, Jilma B, et al. Interleukin-6 level is a powerful predictor of long-term cardiovascular mortality in patients with acute coronary syndrome. Vascular Pharmacology. 2020; 135: 106806.