Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes
Kenneth Caidahl1, Marianne Hartford2, Annica Ravn-Fischer3
1Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Departments of Molecular Medicine and Surgery and Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Insights
Chemokine (C-C motif) ligand 21 (CCL21) levels predict major adverse cardiovascular events and mortality in acute coronary syndrome (ACS) patients. High CCL21 is linked to worse outcomes, while CCL19 indicates heart failure risk.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Immunology
Background:
- Chemokines CCL19 and CCL21 are implicated in cardiovascular diseases like atherosclerosis and heart failure.
- Elevated CCL19 and CCL21 levels correlate with unstable coronary artery disease.
Purpose of the Study:
- To assess the prognostic significance of CCL19 and CCL21 in patients diagnosed with acute coronary syndrome (ACS).
Main Methods:
- Serum samples from 1,146 ACS patients were analyzed within 24 hours of admission.
- Statistical adjustments were performed for GRACE score, ejection fraction, BNP, troponin I, and CRP.
Main Results:
- Higher CCL21 levels at admission were associated with increased long-term risk of major adverse cardiovascular events (MACE) and myocardial infarction.
- Elevated CCL21 also predicted short-term MACE and cardiovascular mortality.
- High CCL19 levels were linked to the development of heart failure post-ACS.
Conclusions:
- CCL21 is an independent predictor of outcomes in ACS patients.
- CCL21 warrants further investigation as a potential biomarker for risk stratification in ACS.
Background:
The chemokines CCL19 and CCL21 are up-regulated in atherosclerotic disease and heart failure, and increased circulating levels are found in unstable versus stable coronary artery disease.
Objectives:
The purpose of this study was to evaluate the prognostic value of CCL19 and CCL21 in acute coronary syndrome (ACS).
Methods:
CCL19 and CCL21 levels were analyzed in serum obtained from ACS patients (n = 1,146) on the first morning after hospital admission. Adjustments were made for GRACE (Global Registry of Acute Coronary Events) score, left ventricular ejection fraction, pro-B-type natriuretic peptide, troponin I, and C-reactive protein levels.
Results:
The major findings were: 1) those having fourth quartile levels of CCL21 on admission of ACS had a significantly higher long-term (median 98 months) risk of major adverse cardiovascular events (MACE) and myocardial infarction in fully adjusted multivariable models; 2) high CCL21 levels at admission were also independently associated with MACE and cardiovascular mortality during short-time (3 months) follow-up; and 3) high CCL19 levels at admission were associated with the development of heart failure.
Conclusions:
CCL21 levels are independently associated with outcome after ACS and should be further investigated as a promising biomarker in these patients.
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