Qi Xiaoyong, Li Shuren, Li Junyong
Cardiac Center of Hebei Provincial Pecople's Hospital, Shijiazhuang, China.
Jpn Heart J. 2003 Sep;44(5):623-32. doi: 10.1536/jhj.44.623.
The objective of the present study was to investigate the prognostic value of plasma interleukin-8 (IL-8) for adverse cardiac events and restenosis in patients with percutaneous coronary intervention (PCI). The pre- and post-procedural peak plasma levels of IL-8 and serum C-reactive protein (CRP) were examined by immunoassay, while adverse cardiae events and restenosis within one year follow-up were observed in 134 consecutive patients who underwent PCI. Angiography revealed that 23.88% (32/134) of the patients had adverse cardiac events and 29.41% (35/119) of the patients had restenosis. Preprocedural levels of IL-8 and CRP and post-procedural peak levels of IL-8 in patients with adverse cardiac events were higher than those without adverse cardiac events (all P < 0.05). The incidence of adverse cardiac events increased from 6.67% in the bottom tertile to 31.82% in the top tertile of IL-8 levels (P = 0.001): a similar trend was observed for restenosis from 10% in low tertile to 51.28% in high tertile of IL-8 levels to 51.8% (P = 0.012). The preprocedural levels of IL-8 (RR = 5.539, CI = 1.720-17.887, P = 0.001) and CRP (RR = 2.031, CI = 1.132-2.049, P = 0.003) were the only independent predictors of adverse cardiac events. The post-procedure peak level of IL-8 (RR = 3.766, CI = 2.990-5.904, P = 0.002) and stent length (RR = 1.468, CI = 1.161-2.022. P = 0.021) were the independent predictors of restenosis. The results demonstrate that the release of IL-8 after PCI is a powerful prognostic factor for cardiac events and restenosis. The higher the peak level of post-procedure IL-8, the lower the event-free survival observed.
本研究的目的是探讨血浆白细胞介素-8(IL-8)对经皮冠状动脉介入治疗(PCI)患者不良心脏事件和再狭窄的预后价值。采用免疫分析法检测PCI术前和术后血浆IL-8和血清C反应蛋白(CRP)的峰值水平,同时观察134例连续接受PCI治疗患者在1年随访期内的不良心脏事件和再狭窄情况。血管造影显示,23.88%(32/134)的患者发生不良心脏事件,29.41%(35/119)的患者发生再狭窄。发生不良心脏事件患者的术前IL-8和CRP水平以及术后IL-8峰值水平高于未发生不良心脏事件的患者(均P<0.05)。不良心脏事件的发生率从IL-8水平最低三分位数的6.67%增至最高三分位数的31.82%(P=0.001);再狭窄也呈现类似趋势,从IL-8水平低三分位数的10%增至高三分位数的51.28%(P=0.012)。术前IL-8水平(RR=5.539,CI=1.720~17.887,P=0.001)和CRP水平(RR=2.031,CI=1.132~2.049,P=0.003)是不良心脏事件的唯一独立预测因素。术后IL-8峰值水平(RR=3.766,CI=2.990~5.904,P=0.002)和支架长度(RR=1.468,CI=1.161~2.022,P=0.021)是再狭窄的独立预测因素。结果表明,PCI术后IL-8的释放是心脏事件和再狭窄的有力预后因素。术后IL-8峰值水平越高,无事件生存率越低。