Meta-analysis of the relationship between interleukin-6 levels and the prognosis and severity of acute coronary syndrome

Yang, Chengzhang; Deng, Zhiyong; Li, Jie; Ren, Zhilei; Liu, Feng

doi:10.6061/clinics/2021/e2690

Cited by 22 publications

(15 citation statements)

References 22 publications

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“…The exclusion criteria were: (i) occurrence of ACS while hospitalized for another reason; (ii) ACS developing within 3 months after a coronary artery bypass graft procedure; (iii) uncontrolled hypertension (systolic blood pressure > 180 mm Hg or diastolic blood pressure > 100 mm Hg (the same criteria used in the SADHART trial)) [ 29 ]; (iv) resting heart rate < 40 beats/min; (v) severe physical illnesses that are life threatening or interfere with ACS recovery; and (vi) persistent clinically significant laboratory abnormalities in complete blood cell counts, thyroid tests, renal function tests, or liver function tests. The research cardiologists treated the ACS of the patients in accordance with international guidelines [ 30 ]. Within 2 weeks (mean ± standard deviation: 6.3 ± 2.4 days) following the occurrence of ACS, patients who met the inclusion criteria and consented to take part in the study were evaluated as inpatients for baseline testing.…”

Section: Methodsmentioning

confidence: 99%

Modifying Effect of the Interleukin-18 Level on the Association between BDNF Methylation and Long-Term Cardiovascular Outcomes in Patients with Acute Coronary Syndrome

Choi

Kang

Kim

et al. 2022

IJMS

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This study investigated the potential modifying effects of the level of the serum interleukin-18 (IL-18) on the association between BDNF methylation status and long-term cardiovascular outcomes in patients with acute coronary syndrome (ACS). Hospitalized ACS patients were recruited sequentially from 2006 to 2012. At baseline, the IL-18 level and BDNF methylation status were evaluated in 969 patients who were followed for major adverse cardiac events (MACEs) for 5–12 years, until 2017 or death. The time to first composite or individual MACE was compared between individuals with lower and higher average BDNF methylation levels (in the low- and high-IL-18 groups, respectively) using a Cox proportional hazards model. After adjusting for potential covariates, the modifying effects of IL-18 and average BDNF methylation levels on the initial composite and individual MACEs were examined. In the high-IL-18 group, but not in the low-IL-18 group, a higher average BDNF methylation level was associated with increases in composite MACEs (HR (95% CI) = 2.15 (1.42–3.26)), all-cause mortality (HR (95% CI) = 1.89 (1.11–3.22)), myocardial infarction (HR (95% CI) = 1.98 (1.07–3.67)), and percutaneous coronary intervention (HR (95% CI) = 1.81 (1.01–3.23)), independent of confounding variables. The interaction effect between the IL-18 and average BDNF methylation levels on composite MACEs (p = 0.019) and myocardial infarction (p = 0.027) was significant after adjusting for covariates. Analysis of BDNF methylation status and IL-18 levels may help identify ACS patients who are most likely to have adverse clinical outcomes.

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Section: Methodsmentioning

confidence: 99%

Modifying Effect of the Interleukin-18 Level on the Association between BDNF Methylation and Long-Term Cardiovascular Outcomes in Patients with Acute Coronary Syndrome

Choi

Kang

Kim

et al. 2022

IJMS

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“…It has been suggested that a high platelet count in the setting of ACS may be associated with increased inflammation and in particular with increased levels of IL-6, which stimulates megakaryocytes both through an increase in thrombopoietin production in the liver 24 and by acting directly on megakaryocytes to stimulate platelet production 25 . IL-6 has previously been identified as an independent predictor of adverse outcomes in ACS 26,27 .…”

Section: Accepted Manuscriptmentioning

confidence: 98%

Association between Platelet Count and Treatment Effect of Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes

et al. 2022

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Background: The relative efficacy and safety of ticagrelor and prasugrel based dual antiplatelet therapy (DAPT) strategies according to the platelet count (PC) in patients with acute coronary syndromes (ACS) has not been defined. Methods: This is a post-hoc analysis of the ISAR-REACT 5 trial, in which patients presenting with ACS were randomized to treatment with ticagrelor versus prasugrel. Patients were divided into quartiles according to PC. The primary endpoint was incidence of death, myocardial infarction, or stroke, safety endpoint was incidence of BARC type 3-5 bleeding at 12 months. Results: 3,943 patients with known PC (997 patients in quartile 1 (Q1), 1,003 in quartile 2 (Q2) {205 ± 10.3 x 109/L}, 961 patients in quartile 3 (Q3) {241 ± 11.7x 109/L} and 982 patients in quartile 4 (Q4) {317 ± 68.6 x 109/L}). There was no significant interaction between treatment arm (ticagrelor versus prasugrel) and PC-group with respect to primary endpoint [Q1: 8.8% versus 6.3%, hazard ratio {HR} =1.41; 95%-CI: [0.89-2.23]; P=0.148, Q2: 9.9% versus 5.8% (HR=1.68 [1.06-2.66]; P=0.027, Q3: 7.8% versus 5.5 % (HR=1.43 [0.87-2.37]; P=0.159, Q4: 10.1% versus 10.1%, (HR=1.05 [0.71-1.57]; P=0.799; P for interaction {pint}=0,482] and with respect to bleeding endpoint [Q1: 5.8% versus 4.2%, (HR=1.41 [0.76-2.63]; P=0.279, Q2: 6.4% versus 3.7% (HR=1.62 [0.85-2.06]; P=0.140, Q3: 4.4% versus 3.0 % (HR=1.53 [0.73-3.18]; P=0.258, Q4: 5.6% versus 8.5%, (HR=0.67 [0.40-1.14]; P=0.138, pint=0.102]. Conclusions: In this analysis, incidence of ischemic and bleeding events at 12 months are comparable across quartiles of platelet count.

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“…It is well established that atherosclerosis is an inflammatory process and biomarkers such as CRP and IL-6 are associated with increased risk of acute coronary events [21]. This suggests that the effect of a Mediterranean diet on these pro-inflammatory biomarkers is likely associated with reducing risk of CVD.…”

Section: Current Evidence On Mediterranean Diet and Inflammationmentioning

confidence: 99%

The anti-inflammatory effects of a Mediterranean diet: a review

Itsiopoulos

Mayr

Thomas

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewChronic noncommunicable diseases remain the leading cause of morbidity and mortality worldwide and the majority are preventable with a healthy diet and lifestyle, but controversy remains as to the best approach. Greater adherence to a traditional Mediterranean diet has consistently been associated with lower morbidity and mortality from cardiovascular disease, diabetes and many cancers, and lower all-cause mortality. Despite the well known benefits on chronic disease risk there remains some scepticism as to the effects of this dietary pattern across populations outside the Mediterranean and the mechanisms of action of this traditional plant-based dietary pattern.This narrative review aims to summarize the latest evidence on the health protective effects of a traditional Mediterranean diet on chronic noncommunicable diseases, specifically focussing on the anti-inflammatory effects of this highly published dietary pattern.Recent findingsRecent high-quality evidence now supports a Mediterranean diet in secondary prevention of cardiovascular disease with impacts on atherosclerosis progression, likely through reduction of systemic inflammation and irrespective of changes in cholesterol or weight. The Mediterranean diet has a low Dietary Inflammatory Index illustrating its anti-inflammatory potential. This dietary pattern beneficially modulates the gut microbiota and immune system, including emerging evidence for efficacy against severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019). Emerging evidence shows clinicians are not routinely recommending a Mediterranean diet despite well known evidence due to barriers such as lack of training, patient materials and concerns about potential patient adherence.SummaryThe physiological mechanisms of action of this healthy diet pattern are becoming better understood to be multisystem and involving the gut. Larger controlled trials investigating mechanistic effects in broader non-Mediterranean populations are warranted. Although reflected in therapeutic guidelines for chronic disease management worldwide there are individual, clinical practice and health system barriers to its implementation that need a multisectoral approach to address.

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Meta-analysis of the relationship between interleukin-6 levels and the prognosis and severity of acute coronary syndrome

Cited by 22 publications

References 22 publications

Modifying Effect of the Interleukin-18 Level on the Association between BDNF Methylation and Long-Term Cardiovascular Outcomes in Patients with Acute Coronary Syndrome

Modifying Effect of the Interleukin-18 Level on the Association between BDNF Methylation and Long-Term Cardiovascular Outcomes in Patients with Acute Coronary Syndrome

Association between Platelet Count and Treatment Effect of Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes

The anti-inflammatory effects of a Mediterranean diet: a review

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