Высокий уровень интерлейкина-6 достоверно повышает риск сердечно-сосудистых событий и смертности

Higher levels of interleukin (IL)-6 are associated with risk for 9 cardiovascular (CV) and mortality outcomes, according to results of a study published in the Journal of the American College of Cardiology. Interleukin-6 is produced by vascular macrophages, endothelial cells, and fibroblasts in response to inflammatory stimuli and is upstream of pathways involved in plaque stability. To better understand the role of IL-6 in CV outcomes, investigators analyzed data for this study from the Cross Cohort Collaboration (CCC), which comprises 25 prospective studies. Participants (N=59,396) were evaluated for incident CV and mortality outcomes on the basis of baseline IL-6 concentration. Individuals in the first (n=14,859), second (n=14,848), third (n=14,822), and fourth (n=14,867) quartiles of IL-6 levels had mean ages of 59.1, 63.2, 65.4, and 66.6 years; 69.7%, 68.1%, 67.0%, and 65.2% were women; 72.5%, 74.0%, 72.2%, and 69.5% were White; and they mean body mass indices (BMIs) of 25.7, 27.5, 28.9, and 30.3, respectively. IL-6 modestly improved risk discrimination beyond traditional factors and hsCRP. The crude incidence rate of myocardial infarction (MI) was 6.1%, stroke was 6.7%, atrial fibrillation (AF) was 10.4%, heart failure (HF) was 7.6%, CV disease (CVD) was 15.1%, coronary heart disease (CHD) was 8.9%, all-cause mortality was 32.8%, CVD-specific mortality was 8.8%, and CHD-specific mortality was 5.3% per 1000 person-years (py). Stratified by IL-6 quartiles, event rates for all outcomes increased with IL-6 levels. In fully adjusted models, risk for all outcomes was significantly higher with the second (adjusted hazard ratio [aHR] range, 1.15-1.34), third (aHR range, 1.27-1.58), and fourth (aHR range, 1.45-2.12) IL-6 level quartiles compared with quartile 1. With every SD increase in the loge IL-6 level, risk for all outcome events increased (aHR range, 1.15-1.34). Conversely, every SD increase in loge high-sensitivity C-reactive protein (hsCRP) level was associated with risk for MI (aHR, 1.08), stroke (aHR, 1.08), HF (aHR, 1.06), and all-cause mortality (aHR, 1.03). Compared with a base predictive model for outcomes (area under the curve [AUC] range, 0.654-0.758), the addition of IL-6 levels (AUC range, 0.665-0.775) generally improved precision more than the addition of hsCRP levels (AUC range, 0.667-0.766), whereas a model with the addition of both IL-6 and hsCRP levels performed similarly to the model with the addition of IL-6 alone (AUC range, 0.670-0.776). In the subgroup analyses, higher IL-6 was associated with risk for all outcomes regardless of chronic kidney disease status, diabetes status, and BMI strata. This study was limited by the fact that IL-6 concentrations were measured at a single timepoint. The study investigators concluded, “…higher circulating IL-6 concentrations were consistently associated with a broad range of cardiovascular events and mortality outcomes. These associations were robust across key clinical subgroups as well as in secondary prevention. Compared with hsCRP, IL-6 showed stronger and more consistent associations. IL-6 modestly improved risk discrimination beyond traditional factors and hsCRP.” Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. This article originally appeared on The Cardiology Advisor