Interleukin-1β and Risk of Premature Death in Patients With Myocardial Infarction

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:76

Article

Silvain, Johanne^1,2,3,4  Kerneis, Mathieu^1,2,3,4  Zeitouni, Michel^1,2,3,4  Lattuca, Benoit^1,2,3,4  Galier, Sophie^2,3,4  Brugier, Delphine^1,2,3,4  Mertens, Emilie¹  Procopi, Niki¹  Suc, Gaspard¹  Salloum, Tomy¹  Frisdal, Eric^2,3,4  Le Goff, Wilfried^2,3,4  Collet, Jean-Philippe^1,2,3,4  Vicaut, Eric⁵  Lesnik, Philippe^2,3,4  Montalescot, Gilles^1,2,3,4  Guerin, Maryse^2,3,4 

[1] Sorbonne Univ, ACT Study Grp, ICAN Inst CardioMetab & Nutr,Inst Cardiol, INSERM,UMRS1166,Hop Pitie Salpetriere,AP HP, Paris, France

[2] Hop Pitie, INSERM, UMRSH66, Paris, France

[3] Sorbonne Univ, Paris, France

[4] Hop Pitie, ICAN Inst CardioMetab & Nutr, Paris, France

[5] Hop Fernand Widal, AP HP, ACT Study Grp, Unite Rech Clin, Paris, France

关键词: C-reactive protein;    inflammation;    interleukin-1 beta;    mortality;    myocardial infarction;   

DOI  :  10.1016/j.jacc.2020.08.026

来源: Elsevier

【 摘 要 】

BACKGROUND Inhibition of the interleukin (IL)-1 beta innate immunity pathway is associated with anti-inflammatory effects and a reduced risk of recurrent cardiovascular events in stable patients with previous myocardial infarction (MI) and elevated high-sensitivity C-reactive protein (hs-CRP). OBJECTIVES This study assessed the association between IL-1 beta level with all-cause mortality in patients with acute ST-segment elevation MI who underwent primary percutaneous coronary intervention and the interplay between IL-1 beta and hs-CRP concentrations on the risk of premature death. METHODS IL-1 beta concentration was measured in 1,398 patients with ST-segment elevation MI who enrolled in a prospective cohort. Crude and hazard ratios for all-cause and cardiovascular mortality were analyzed at 90 days and 1 year using multivariate Cox proportional regression analysis. Major adverse cardiovascular events (MACEs) were analyzed. RESULTS IL-1 beta concentration measured at admission was associated with all-cause mortality at 90 days (adjusted hazard ratio [adjHR]: 1.47 per 1 SD increase; 95% confidence interval [CI]: 1.16 to 1.87; p < 0.002). The relation was nonlinear, and the highest tertile of IL-1 beta was associated with higher mortality rates at 90 days (adjHR: 2.78; 95% CI: 1.61 to 4.79; p = 0.0002) and at 1 year (adjHR: 1.93; 95% CI: 1.21 to 3.06; p = 0.005), regardless of the hs-CRP concentration. Significant relationships were equally observed when considering cardiovascular mortality and MACEs at 90 days (adjHR: 2.42; 95% CI: 1.36 to 4.28; p = 0.002, and adjHR: 2.29; 95% CI: 1.31 to 4.01; p = 0.004, respectively) and at 1 year (adjHR: 2.32; 95% CI: 1.36 to 3.97; p = 0.002, and adjHR: 2.35; 95% CI: 1.39 to 3.96; p = 0.001, respectively). CONCLUSIONS IL-1 beta measured at admission in patients with acute MI was independently associated with the risk of mortality and recurrent MACEs. (C) 2020 by the American College of Cardiology Foundation.

【 授权许可】

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