Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/7371
Title: Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes
Authors: Correia, Luis Cláudio Lemos
Andrade, Bruno de Bezerril
Borges, Valeria de Matos
Clarêncio, Jorge
Bittencourt, Ana P.
Freitas, Rafael
Souza, Alexandre C.
Almeida, Maria da Conceição Chagas de
Leal, Jamile
Esteves, J. Péricles
Barral Netto, Manoel
Affilliation: Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil / Medical School of Bahia. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil
Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil
Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil
Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil
Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil
Medical School of Bahia. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Institute of Investigation in Immunology (iii). Science and Technology National Institute (INCT). Bahia, BA, BraSil
Abstract: Increased cytokine and chemokine levels are associated with cardiovascular events in patients with non-ST-elevation acute coronary syndromes (ACS), but the incremental prognostic value of these inflammatory markers is not known. We determined if cytokine and chemokine assessment adds prognostic information to the GRACE Score in patients with ACS. METHODS: Five cytokines (interleukin (IL)-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor (TNF)-alpha soluble receptor I), five chemokines (IL-8, CCL5, CXCL9, CCL2, and CXCL10) and C-reactive protein (CRP) were measured at admission of 87 patients admitted with ACS. RESULTS: During hospitalization, the incidence of cardiovascular events was 13% (7 deaths, 1 nonfatal acute myocardial infarction, and 3 refractory unstable angina). Individuals who developed events had significantly greater levels of CRP, IL-1beta, IL-12, TNF-alpha, IL-8, CXCL9 and CCL2, compared with those free of events. Thus, these markers were used to build an Inflammatory Score, by the input of one point for each of these variables above the 75th percentile. After adjustment for the GRACE Score, the Inflammatory Score independently predicted events (OR=1.80; 95% CI=1.12-1.88). Incorporation of the Inflammatory Score into the GRACE Score promoted a C-statistics improvement from 0.77 (95% CI=0.58-0.96) to 0.85 (95% CI=0.71-1.0). Net reclassification improvement obtained with GRACE-Inflammatory Score was 13% (P=0.007), indicating a significant reclassification. When only CRP was incorporated into GRACE, the increase on C-statistics was not relevant (from 0.77 to 0.80). CONCLUSION: Cytokines and chemokines measured at admission add prognostic information to the GRACE Score in patients admitted with ACS.
Keywords: Cytokines
Chemokines
C-reactive protein
Acute coronary syndromes
DeCS: Síndrome Coronariana Aguda/sangue
Síndrome Coronariana Aguda/diagnóstico
Quimiocinas/sangue
Citocinas/sangue
Idoso
Proteína C-Reativa/análise
Feminino
Humanos
Masculino
Valor Preditivo dos Testes
Prognóstico
Issue Date: 2010
Publisher: Elsevier B.V
Citation: CORREIA, L. C. L. et al. Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes. Clinica Chimica Acta, v. 411, p. 540–545, 2010.
DOI: 10.1016/j.cca.2010.01.011
ISSN: 1873-3492
Copyright: open access
Appears in Collections:IGM - Artigos de Periódicos

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