Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Eur J Heart Fail. 2014 Jan;16(1):68-75. doi: 10.1093/eurjhf/hft125. Epub 2013 Dec 3.
We investigated the ability of prototypical inflammatory cytokines to predict clinical outcomes in a large population of patients with chronic systolic heart failure (HF).
Serum levels of tumour necrosis factor-α (TNF-α), soluble TNF receptors type I and II (sTNF-RI and sTNF-RII), and the chemokines monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) were analysed in 1464 patients with chronic ischaemic systolic HF in the CORONA study, aged ≥ 60 years, in NYHA class II-IV, and related to the primary endpoint (n = 320), as well as any coronary event (n = 255), all-cause mortality (n = 329), cardiovascular (CV) mortality (n = 268), and the composite endpoint hospitalization from worsening heart failure (WHF) or CV mortality (n = 547). TNF-α, sTNF-RI, sTNF-RII, and IL-8, but not MCP-1, were independent predictors of all endpoints except the coronary endpoint in multivariable models including conventional clinical variables. After further adjustment for estimated glomerular filtration rate, the ApoB/ApoA-1 ratio, NT-proBNP, and high-sensitivity C-reactive protein, only IL-8 remained a significant predictor of all endpoints (except the coronary endpoint), while sTNF- RI remained independently associated with CV mortality. Adding IL-8 to the full model led to a significant improvement in net reclassification for all-cause mortality and CV hospitalization, but only a borderline significant improvement for the primary endpoint, CV mortality, and the composite endpoint WHF hospitalization or CV mortality.
Our study supports a relationship between IL-8 and outcomes in patients with chronic HF. However, the clinical usefulness of IL-8 as a biomarker in an unselected HF population is at present unclear.
我们研究了典型炎症细胞因子在患有慢性收缩性心力衰竭（HF）的大量患者人群中预测临床结局的能力。
在 CORONA 研究中，分析了 1464 例年龄≥60 岁、NYHA 分级 II-IV 级、慢性缺血性收缩性 HF 患者的肿瘤坏死因子-α（TNF-α）、可溶性 TNF 受体 I 和 II（sTNF-RI 和 sTNF-RII）、趋化因子单核细胞趋化蛋白-1（MCP-1）和白细胞介素-8（IL-8）血清水平与主要终点（n=320）以及任何冠状动脉事件（n=255）、全因死亡率（n=329）、心血管（CV）死亡率（n=268）和因恶化性心力衰竭（WHF）或 CV 死亡率住院的复合终点（n=547）的关系。TNF-α、sTNF-RI、sTNF-RII 和 IL-8，但不是 MCP-1，在包括常规临床变量的多变量模型中是所有终点的独立预测因子，除了冠状动脉终点。在进一步调整估算肾小球滤过率、ApoB/ApoA-1 比值、NT-proBNP 和高敏 C 反应蛋白后，仅 IL-8 仍然是所有终点（除了冠状动脉终点）的显著预测因子，而 sTNF-RI 仍然与 CV 死亡率独立相关。将 IL-8 添加到全模型中可显著改善全因死亡率和 CV 住院的净重新分类，但仅对主要终点、CV 死亡率和复合终点 WHF 住院或 CV 死亡率有边缘显著改善。
我们的研究支持 IL-8 与慢性 HF 患者结局之间的关系。然而，目前尚不清楚 IL-8 作为未选择 HF 人群中生物标志物的临床有用性。
