血清白细胞介素-6水平对冠状动脉支架置入术后患者非靶病变进展的影响

Effect of Serum IL-6 Levels on the Progression of Non-Target Lesions in Patients after Coronary Stenting.

作者信息

Sha Xiang, Wang Wei, Qiu Jie, Wang Ruzhu

机构信息

Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, 225300 Taizhou, Jiangsu, China.

出版信息

Rev Cardiovasc Med. 2024 Jun 27;25(7):234. doi: 10.31083/j.rcm2507234. eCollection 2024 Jul.

DOI:10.31083/j.rcm2507234

PMID:39139413

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11317311/

Abstract

BACKGROUND

percutaneous coronary intervention (PCI) has become the mainstay of treatment for atherosclerotic cardiovascular disease (ASCVD). Inflammatory factors have been shown to be involved in the initiation and progression of ASCVD. After PCI, the persistence of inflammation, especially the inflammation released at the target lesion, may affect the stability of non-target lesion plaques. Interleukin-6 (IL-6) is one of the most common inflammatory factors, however studies about the influence of IL-6 on the progression of non-target lesions (NTLs) of coronary artery are limited. This study investigated whether serum IL-6 levels can affect the progression of NTLs after coronary stent implantation.

METHODS

We performed a retrospective cohort study including 441 patients undergoing coronary angiography (CAG) and stent implantation, who had at least one NTL, between January 2019 and December 2021. They underwent followup CAG 9 to 12 months after PCI. Quartile grouping was based on serum IL-6 levels following readmission. The relationship between serum IL-6 levels and the progression of NTLs after coronary stent implantation was analyzed by using logistic regression analysis and restricted cubic spline regression. Predictive value of IL-6 on NTL progression was evaluated using the receiver operating characteristic (ROC) curve.

RESULTS

When compared to the first quartile (Q1) group, the probability of NTL progression was increased in Q2 (adjusted odds ratio (aOR) 3.06, 95% CI 1.29-7.29), Q3 (aOR 3.55, 95% CI 1.52-8.26), and Q4 group (aOR 7.51, 95% CI 3.30-17.05), with a trend test 0.001. With the increase of IL-6 levels, the risk of progression of NTLs gradually increased, and there was a non-linear relationship between IL-6 and progression of NTLs ( 0.001). The ROC curve showed that the critical value of the serum IL-6 level was 12.652 pg/mL (area under the curve is 0.673, sensitivity is 54.5%, specificity is 70.9%, 0.05).

CONCLUSIONS

A high serum IL-6 level is an independent risk factor for the progression of NTLs after coronary stent implantation, and has certain predictive value for the progression of NTLs.

摘要

背景

经皮冠状动脉介入治疗（PCI）已成为动脉粥样硬化性心血管疾病（ASCVD）治疗的主要手段。炎症因子已被证明参与了ASCVD的发生和发展。PCI术后，炎症的持续存在，尤其是靶病变处释放的炎症，可能会影响非靶病变斑块的稳定性。白细胞介素-6（IL-6）是最常见的炎症因子之一，然而关于IL-6对冠状动脉非靶病变（NTLs）进展影响的研究有限。本研究调查了血清IL-6水平是否会影响冠状动脉支架植入术后NTLs的进展。

方法

我们进行了一项回顾性队列研究，纳入了2019年1月至2021年12月期间441例行冠状动脉造影（CAG）和支架植入术且至少有一个NTL的患者。他们在PCI术后9至12个月接受随访CAG。四分位数分组基于再次入院后的血清IL-6水平。采用逻辑回归分析和限制性立方样条回归分析血清IL-6水平与冠状动脉支架植入术后NTLs进展的关系。使用受试者工作特征（ROC）曲线评估IL-6对NTL进展的预测价值。

结果

与第一四分位数（Q1）组相比，Q2组（调整优势比（aOR）3.06，95%可信区间1.29 - 7.29）、Q3组（aOR 3.55，95%可信区间1.52 - 8.26）和Q4组（aOR 7.51，95%可信区间3.30 - 17.05）NTL进展的概率增加，趋势检验P<0.001。随着IL-6水平的升高，NTLs进展的风险逐渐增加，且IL-6与NTLs进展之间存在非线性关系（P<0.001）。ROC曲线显示血清IL-6水平的临界值为12.652 pg/mL（曲线下面积为0.673，敏感性为54.5%，特异性为70.9%，P<0.05）。