Elevated IL-27 in patients with acute coronary syndrome is associated with adverse ventricular remodeling and increased risk of recurrent myocardial infarction and cardiovascular death. (October 2019)

• Record Type: Journal Article
• Authors: Grufman, Helena; Yndigegn, Troels; Gonçalves, Isabel; Nilsson, Jan; Schiopu, Alexandru
• Is Part Of: Cytokine. Volume 122(2019)
• Publication Date: 2019-10
• Subjects: IL-27 -- Myocardial infarction -- Cardiovascular death -- Ventricular remodeling -- Inflammation; AMI acute myocardial infarction -- CV cardiovascular -- HR hazard ratio -- CI confidence interval -- LDL low-density lipoprotein cholesterol -- HDL high-density lipoprotein cholesterol -- hsTnT high-sensitive cardiac troponin T -- hsCRP high-sensitive C-reactive protein -- ASA acetylsalicylic acid -- ACEi angiotensin converting enzyme inhibitors -- ARB angiotensin II receptor blockers -- LVEF LV ejection fraction -- LVEDV LV end diastolic volume -- LVESV left ventricular end systolic volume -- LVID left inner ventricular diameter -- LVMI left ventricular mass index -- LAVI left atrial volume index; Cytokines -- Periodicals; 571.844
• DOI: 10.1016/j.cyto.2017.11.002
• Languages: English
• ISSNs: 1043-4666

Abstract

Highlights: High IL-27 in acute coronary syndrome patients is associated with worse prognosis. The relationship is independent of infarct size, other risk factors and medication. IL-27 correlates with deleterious cardiac remodeling during the first year. Patients with high IL-27 suffer deterioration of left ventricular function. Abstract: Background and aims: IL-27 is an immunoregulatory cytokine belonging to the IL-6/IL-12 family that was found to be elevated in acute coronary syndrome (ACS) patients. We investigated whether IL-27 is related to post-ischemic cardiac remodeling and long-term prognosis in this patient group. Methods: We included 524 ACS patients, defined as acute myocardial infarction (AMI) or unstable angina (UA). A subgroup of 107 patients donated blood samples 6 weeks after the index event, and underwent a follow-up echocardiographical examination at 1 year. We measured plasma levels of IL-27, high sensitivity troponin T (hsTNT), C-reactive protein (hsCRP) and cystatin C at baseline and in the 6-week samples. The median follow-up period of the cohort was 2.2 years. Results: The incidence of the combined end-point of AMI and cardiovascular death was higher in patients with plasma IL-27 within the top two tertiles both at baseline and after 6 weeks. After correction for cardiovascular risk factors, medication, hsTNT, hsCRP, and eGFR, patients with baseline IL-27 levels within the highest tertile had a significantly elevated risk for the combined end-point compared with the lowest tertile (hazard ratio 2.70, 95% CI 1.06–6.90, p = .038). Additionally, higher baseline IL-27 levels were associated with deleterious left ventricular remodeling and deterioration of systolic and diastolic function during the first year of follow-up. Conclusions: Elevated IL-27 at the time of an ACS is independently related to impaired cardiac function and worse long-term prognosis. Our data warrants further mechanistic studies to elucidate the involvement of IL-27 in cardiac repair and remodeling after ACS.