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Predictive Value of Blood Interleukin-6 Level in Patients with Acute Coronary Syndrome: A Meta-analysis
Hengdong Li1,2, Kaidong Cen1, Weifeng Sun1
1Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Insights
Elevated interleukin-6 levels in acute coronary syndrome (ACS) patients are linked to increased risks of major adverse cardiovascular events (MACE) and mortality. This finding suggests interleukin-6 can aid in risk stratification for ACS patients.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Inflammation Research
Background:
- Conflicting results exist regarding interleukin-6 (IL-6) and adverse outcomes in acute coronary syndrome (ACS).
- IL-6 is a pro-inflammatory cytokine implicated in cardiovascular disease pathogenesis.
Purpose of the Study:
- To conduct a meta-analysis evaluating the predictive value of elevated blood IL-6 levels for adverse outcomes in ACS patients.
- To synthesize existing evidence on the association between IL-6 and major adverse cardiovascular events (MACE), all-cause mortality, and cardiovascular mortality in ACS.
Main Methods:
- Systematic literature search of PubMed and Embase databases up to December 31, 2019.
- Inclusion of observational studies and post hoc analyses of randomized controlled trials involving ACS patients.
- Pooling of multivariable-adjusted risk ratios (RR) and 95% confidence intervals (CI) for highest versus lowest IL-6 categories.
Main Results:
- Thirteen studies with 30,289 ACS patients were included.
- Elevated IL-6 was associated with increased risk for MACE (RR 1.29, 95% CI 1.12-1.48), all-cause mortality (RR 1.50, 95% CI 1.35-1.67), and cardiovascular mortality (RR 1.55, 95% CI 1.06-2.28).
- Predictive value of IL-6 for MACE was consistent across various subgroups.
Conclusions:
- Increased blood IL-6 levels are independently associated with a higher risk of MACE, cardiovascular mortality, and all-cause mortality in ACS patients.
- Measuring blood IL-6 levels holds potential for improving risk stratification in ACS management.
Objective:
Conflicting results have been reported on the association between blood level of interleukin-6 and adverse outcomes in patients with acute coronary syndrome (ACS). The current meta-analysis aimed to evaluate the predictive utility of elevated blood interleukin-6 level in patients with ACS.
Methods:
A systematically literature search was performed using PubMed and Embase databases up to December 31, 2019. Observational studies or post hoc analysis of randomized controlled trials investigating the values of blood interleukin-6 level for predicting major adverse cardiovascular events (MACE including death, re-infarction, revascularization, angina, heart failure, malignant arrhythmia, or stroke), all-cause mortality or cardiovascular mortality in ACS patients were eligible. The predictive values were summarized by pooling the multivariable-adjusted risk ratio (RR) and 95% confidence intervals (CI) for the highest versus lowest category of interleukin-6 level.
Results:
Thirteen studies enrolling 30,289 patients with ACS were included. When comparing the highest with lowest category of interleukin-6 level, the pooled RR was 1.29 (95% CI 1.12-1.48) for MACE, 1.50 (95% CI 1.35-1.67) for all-cause mortality, and 1.55 (95% CI 1.06-2.28) for cardiovascular mortality, respectively. Moreover, the predictive values of interleukin-6 level on MACE were consistently found in different study designs, subtypes of patients, sample sizes, follow-up duration, and cutoff value of interleukin-6 elevation subgroups.
Conclusion:
Increased blood level of interleukin-6may be independently associated with higher risk of MACE, cardiovascular and all-cause mortality in patients with ACS. Measurement of blood interleukin-6 level has potential to improve risk stratification of ACS.
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