Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Surgical Center of Structural Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Hellenic J Cardiol. 2024 Jul-Aug;78:25-35. doi: 10.1016/j.hjc.2023.08.013. Epub 2023 Aug 29.
Cytokines are strongly associated with coronary artery disease (CAD); however, few studies have explored the relevance of cytokines in coronary chronic total occlusion (CTO). This study aimed to clarify the association of cytokines with CTO and its procedural outcomes.
A total of 526 patients with suspected CAD but not acute myocardial infarction were enrolled and divided into CTO (n = 122) and non-CTO (n = 404) groups based on coronary angiography. Furthermore, serum levels of 12 cytokines [Interleukin-1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, tumor necrosis factor-α (TNF-α), interferon-α (IFN-α), and IFN-γ] were measured for each patient.
Patients with CTO had higher rates of male (P = 0.001), smoking (P = 0.014), and diabetes (P = 0.008); higher levels of IL-6 (P < 0.001), total triglycerides (P = 0.020), serum creatine (P = 0.001), and high-sensitivity troponin I (P = 0.001); and lower IL-4 (P < 0.001), total cholesterol (P = 0.027), and high-density lipoprotein cholesterol (HDL-C) (P < 0.001) levels compared to those without CTO. IL-4 (OR = 0.216, 95%CI:0.135-0.345, P < 0.001), IL-6 (OR = 1.248, 95%CI:1.165-1.337, P < 0.001), and HDL-C (OR = 0.047, 95%CI:0.010-0.221, P < 0.001) were identified as independent predictors of CTO. And good predictive performance (AUC = 0.876) for CTO, with a sensitivity of 81.96% and specificity of 81.19%, could be achieved by combining these three predictors. Furthermore, patients with procedural success had younger age (P = 0.004) and lower serum IL-6 levels (P = 0.039) compared to those with procedural failure, and IL-6 levels (OR = 0.962, 95%CI: 0.931-0.995, P = 0.023) were associated with procedural success.
IL-4, IL-6, and HDL-C levels were strongly associated with CTO, and IL-6 also linked to procedural outcomes of CTO.
细胞因子与冠状动脉疾病（CAD）密切相关；然而，很少有研究探讨细胞因子在冠状动脉慢性完全闭塞（CTO）中的相关性。本研究旨在阐明细胞因子与 CTO 及其手术结果的关系。
共纳入 526 例疑似 CAD 但无急性心肌梗死的患者，根据冠状动脉造影结果分为 CTO 组（n=122）和非 CTO 组（n=404）。此外，检测每位患者 12 种细胞因子[白细胞介素-1β（IL-1β）、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12p70、IL-17、肿瘤坏死因子-α（TNF-α）、干扰素-α（IFN-α）和 IFN-γ]的血清水平。
与非 CTO 组相比，CTO 组患者中男性（P=0.001）、吸烟（P=0.014）和糖尿病（P=0.008）比例更高；IL-6（P<0.001）、总三酰甘油（P=0.020）、血清肌酸（P=0.001）和高敏肌钙蛋白 I（P=0.001）水平更高；IL-4（P<0.001）、总胆固醇（P=0.027）和高密度脂蛋白胆固醇（HDL-C）（P<0.001）水平更低。IL-4（OR=0.216，95%CI：0.135-0.345，P<0.001）、IL-6（OR=1.248，95%CI：1.165-1.337，P<0.001）和 HDL-C（OR=0.047，95%CI：0.010-0.221，P<0.001）被确定为 CTO 的独立预测因子。并且，通过联合这三个预测因子，可以实现对 CTO 的高预测性能（AUC=0.876），其灵敏度为 81.96%，特异性为 81.19%。此外，与手术失败组相比，手术成功组患者年龄较小（P=0.004），血清 IL-6 水平较低（P=0.039），IL-6 水平（OR=0.962，95%CI：0.931-0.995，P=0.023）与手术成功相关。
IL-4、IL-6 和 HDL-C 水平与 CTO 密切相关，IL-6 也与 CTO 的手术结果相关。
