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Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes.
Clin Chim Acta. 2010 Apr 02; 411(7-8):540-5.CC

Abstract

BACKGROUND

Increased cytokine and chemokine levels are associated with cardiovascular events in patients with non-ST-elevation acute coronary syndromes (ACS), but the incremental prognostic value of these inflammatory markers is not known. We determined if cytokine and chemokine assessment adds prognostic information to the GRACE Score in patients with ACS.

METHODS

Five cytokines (interleukin (IL)-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor (TNF)-alpha soluble receptor I), five chemokines (IL-8, CCL5, CXCL9, CCL2, and CXCL10) and C-reactive protein (CRP) were measured at admission of 87 patients admitted with ACS.

RESULTS

During hospitalization, the incidence of cardiovascular events was 13% (7 deaths, 1 nonfatal acute myocardial infarction, and 3 refractory unstable angina). Individuals who developed events had significantly greater levels of CRP, IL-1beta, IL-12, TNF-alpha, IL-8, CXCL9 and CCL2, compared with those free of events. Thus, these markers were used to build an Inflammatory Score, by the input of one point for each of these variables above the 75th percentile. After adjustment for the GRACE Score, the Inflammatory Score independently predicted events (OR=1.80; 95% CI=1.12-1.88). Incorporation of the Inflammatory Score into the GRACE Score promoted a C-statistics improvement from 0.77 (95% CI=0.58-0.96) to 0.85 (95% CI=0.71-1.0). Net reclassification improvement obtained with GRACE-Inflammatory Score was 13% (P=0.007), indicating a significant reclassification. When only CRP was incorporated into GRACE, the increase on C-statistics was not relevant (from 0.77 to 0.80).

CONCLUSION

Cytokines and chemokines measured at admission add prognostic information to the GRACE Score in patients admitted with ACS.

Authors+Show Affiliations

Portuguese Hospital, Salvador/BA, Brazil. lccorreia@terra.com.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20083097

Citation

Correia, Luis C L., et al. "Prognostic Value of Cytokines and Chemokines in Addition to the GRACE Score in non-ST-elevation Acute Coronary Syndromes." Clinica Chimica Acta; International Journal of Clinical Chemistry, vol. 411, no. 7-8, 2010, pp. 540-5.
Correia LC, Andrade BB, Borges VM, et al. Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes. Clin Chim Acta. 2010;411(7-8):540-5.
Correia, L. C., Andrade, B. B., Borges, V. M., Clarêncio, J., Bittencourt, A. P., Freitas, R., Souza, A. C., Almeida, M. C., Leal, J., Esteves, J. P., & Barral-Netto, M. (2010). Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes. Clinica Chimica Acta; International Journal of Clinical Chemistry, 411(7-8), 540-5. https://doi.org/10.1016/j.cca.2010.01.011
Correia LC, et al. Prognostic Value of Cytokines and Chemokines in Addition to the GRACE Score in non-ST-elevation Acute Coronary Syndromes. Clin Chim Acta. 2010 Apr 2;411(7-8):540-5. PubMed PMID: 20083097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes. AU - Correia,Luis C L, AU - Andrade,Bruno B, AU - Borges,Valéria M, AU - Clarêncio,Jorge, AU - Bittencourt,Ana P, AU - Freitas,Rafael, AU - Souza,Alexandre C, AU - Almeida,Maria C, AU - Leal,Jamile, AU - Esteves,J Péricles, AU - Barral-Netto,Manoel, Y1 - 2010/01/18/ PY - 2009/10/21/received PY - 2009/12/21/revised PY - 2010/01/07/accepted PY - 2010/1/20/entrez PY - 2010/1/20/pubmed PY - 2010/5/8/medline SP - 540 EP - 5 JF - Clinica chimica acta; international journal of clinical chemistry JO - Clin Chim Acta VL - 411 IS - 7-8 N2 - BACKGROUND: Increased cytokine and chemokine levels are associated with cardiovascular events in patients with non-ST-elevation acute coronary syndromes (ACS), but the incremental prognostic value of these inflammatory markers is not known. We determined if cytokine and chemokine assessment adds prognostic information to the GRACE Score in patients with ACS. METHODS: Five cytokines (interleukin (IL)-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor (TNF)-alpha soluble receptor I), five chemokines (IL-8, CCL5, CXCL9, CCL2, and CXCL10) and C-reactive protein (CRP) were measured at admission of 87 patients admitted with ACS. RESULTS: During hospitalization, the incidence of cardiovascular events was 13% (7 deaths, 1 nonfatal acute myocardial infarction, and 3 refractory unstable angina). Individuals who developed events had significantly greater levels of CRP, IL-1beta, IL-12, TNF-alpha, IL-8, CXCL9 and CCL2, compared with those free of events. Thus, these markers were used to build an Inflammatory Score, by the input of one point for each of these variables above the 75th percentile. After adjustment for the GRACE Score, the Inflammatory Score independently predicted events (OR=1.80; 95% CI=1.12-1.88). Incorporation of the Inflammatory Score into the GRACE Score promoted a C-statistics improvement from 0.77 (95% CI=0.58-0.96) to 0.85 (95% CI=0.71-1.0). Net reclassification improvement obtained with GRACE-Inflammatory Score was 13% (P=0.007), indicating a significant reclassification. When only CRP was incorporated into GRACE, the increase on C-statistics was not relevant (from 0.77 to 0.80). CONCLUSION: Cytokines and chemokines measured at admission add prognostic information to the GRACE Score in patients admitted with ACS. SN - 1873-3492 UR - https://www.unboundmedicine.com/medline/citation/20083097/Prognostic_value_of_cytokines_and_chemokines_in_addition_to_the_GRACE_Score_in_non_ST_elevation_acute_coronary_syndromes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009-8981(10)00024-0 DB - PRIME DP - Unbound Medicine ER -