Related Experiment Videos
Prognostic value of interleukin-1 receptor antagonist in patients undergoing percutaneous coronary intervention
Giuseppe Patti1, Germano Di Sciascio, Andrea D'Ambrosio
1Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy.
Insights
Pre-procedure interleukin-1 receptor antagonist (IL-1Ra) plasma levels predict major adverse cardiac events (MACE) in patients undergoing percutaneous coronary intervention (PCI). Higher IL-1Ra levels indicate a greater risk of MACE, offering valuable prognostic insight.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Elevated inflammatory markers like C-reactive protein (CRP) are linked to adverse outcomes in coronary artery disease (CAD) patients post-PCI.
- Interleukin-1 receptor antagonist (IL-1Ra) is an inflammatory marker with potential prognostic value.
Purpose of the Study:
- To assess the predictive capability of preprocedural IL-1Ra plasma levels for long-term MACE in unselected CAD patients undergoing PCI.
- To identify independent predictors of MACE following PCI.
Main Methods:
- Prospective follow-up study of 73 consecutive patients undergoing PCI for symptomatic CAD.
- Measurement of preprocedural IL-1Ra and CRP plasma levels.
- Clinical assessment for MACE at 3, 6, 12, and 18 months.
- Logistic regression analysis to identify independent predictors of MACE.
Main Results:
- IL-1Ra levels in the highest quartile were the sole independent predictor of MACE at 18 months (19% vs 0%; p=0.032).
- High preprocedural CRP levels showed a non-significant trend towards increased MACE risk (p=0.09).
- Successful PCI achieved in all patients, with stenting in 86%.
Conclusions:
- Preprocedural IL-1Ra plasma levels are a valuable independent predictor of MACE in unselected patients undergoing PCI.
- IL-1Ra may serve as a useful biomarker for risk stratification in CAD patients undergoing revascularization.
Abstract:
Elevated plasma levels of inflammatory markers, such as C-reactive protein (CRP), have been associated with adverse outcome in selected patients with coronary artery disease (CAD) treated with coronary angioplasty or stenting. The aim of this study was to evaluate the predictive value of preprocedural interleukin-1 receptor antagonist (IL-1Ra) plasma levels for long-term major adverse cardiac events (MACE) in a series of unselected patients with symptomatic CAD treated with percutaneous coronary intervention (PCI). Seventy-three consecutive patients (62 men, aged 62 +/- 9 years) undergoing PCI were enrolled in a prospective follow-up study. IL-1Ra and CRP plasma levels were measured before the procedure; 36 patients (49%) had unstable angina pectoris on admission, 37 (51%) had chronic stable angina pectoris, and 30 (41%) had multivessel CAD, 15 of whom underwent multivessel PCI. Success was achieved in all 73 patients, with coronary stenting performed in 63 (86%). Follow-up clinical assessment included occurrence of MACE at 3, 6, 12, and 18 months. Logistic regression analysis, performed to determine independent predictors of MACE, identified IL-1Ra levels in the upper quartile as the only independent predictive factor of MACE at 18 months (19% in the fourth quartile vs 0% in the first quartile; p = 0.032). Patients with high preprocedural CRP levels (fourth quartile) had a nonsignificant increased risk of MACE (p = 0.09). Thus, preprocedural IL-1Ra plasma levels appear to be a valuable independent predictive factor of MACE in unselected patients undergoing PCI.