Immunological Investigations ( IF 2.8 ) Pub Date : 2020-08-18 , DOI: 10.1080/08820139.2020.1795876 Hengdong Li 1, 2 , Kaidong Cen 1 , Weifeng Sun 1 , Beili Feng 1, 2
ABSTRACT
Objective
Conflicting results have been reported on the association between blood level of interleukin-6 and adverse outcomes in patients with acute coronary syndrome (ACS). The current meta-analysis aimed to evaluate the predictive utility of elevated blood interleukin-6 level in patients with ACS.
Methods
A systematically literature search was performed using PubMed and Embase databases up to December 31, 2019. Observational studies or post hoc analysis of randomized controlled trials investigating the values of blood interleukin-6 level for predicting major adverse cardiovascular events (MACE including death, re-infarction, revascularization, angina, heart failure, malignant arrhythmia, or stroke), all-cause mortality or cardiovascular mortality in ACS patients were eligible. The predictive values were summarized by pooling the multivariable-adjusted risk ratio (RR) and 95% confidence intervals (CI) for the highest versus lowest category of interleukin-6 level.
Results
Thirteen studies enrolling 30,289 patients with ACS were included. When comparing the highest with lowest category of interleukin-6 level, the pooled RR was 1.29 (95% CI 1.12–1.48) for MACE, 1.50 (95% CI 1.35–1.67) for all-cause mortality, and 1.55 (95% CI 1.06–2.28) for cardiovascular mortality, respectively. Moreover, the predictive values of interleukin-6 level on MACE were consistently found in different study designs, subtypes of patients, sample sizes, follow-up duration, and cutoff value of interleukin-6 elevation subgroups.
Conclusion
Increased blood level of interleukin-6may be independently associated with higher risk of MACE, cardiovascular and all-cause mortality in patients with ACS. Measurement of blood interleukin-6 level has potential to improve risk stratification of ACS.
中文翻译:
急性冠脉综合征患者血液白细胞介素 6 水平的预测价值:一项 Meta 分析
摘要
客观的
在急性冠状动脉综合征 (ACS) 患者的血液中 IL-6 水平与不良结局之间的关联方面,已报道了相互矛盾的结果。目前的荟萃分析旨在评估升高的血液白细胞介素 6 水平对 ACS 患者的预测效用。
方法
截至 2019 年 12 月 31 日,使用 PubMed 和 Embase 数据库进行了系统的文献检索。观察性研究或随机对照试验的事后分析,调查血液白细胞介素 6 水平对预测主要不良心血管事件(MACE 包括死亡、再ACS 患者的脑梗死、血运重建、心绞痛、心力衰竭、恶性心律失常或中风)、全因死亡率或心血管死亡率均符合条件。通过汇总白细胞介素 6 水平最高与最低类别的多变量调整风险比 (RR) 和 95% 置信区间 (CI) 来总结预测值。
结果
纳入了 30,289 名 ACS 患者的 13 项研究。在比较最高和最低类别的白细胞介素 6 水平时,MACE 的汇总 RR 为 1.29(95% CI 1.12-1.48),全因死亡率为 1.50(95% CI 1.35-1.67),1.55(95% CI 1.06-2.28)分别用于心血管死亡率。此外,IL-6 水平对 MACE 的预测值在不同的研究设计、患者亚型、样本量、随访时间和白细胞介素 6 升高亚组的截止值中一致发现。
结论
血液中 IL-6 水平升高可能与 ACS 患者的 MACE、心血管和全因死亡率升高风险独立相关。血液白细胞介素 6 水平的测量有可能改善 ACS 的风险分层。