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  • Batra, GoravUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi (författare)

Interleukin 6 and Cardiovascular Outcomes in Patients With Chronic Kidney Disease and Chronic Coronary Syndrome

  • Artikel/kapitelEngelska2021

Förlag, utgivningsår, omfång ...

  • American Medical Association (AMA),2021
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-463936
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-463936URI
  • https://doi.org/10.1001/jamacardio.2021.3079DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Importance: Inflammation promotes cardiovascular disease and anti-inflammatory treatment reduces cardiovascular events in patients with chronic coronary syndrome. Chronic kidney disease (CKD) is a risk factor for cardiovascular disease. It is unclear how inflammation mediated by interleukin 6 (IL-6) in patients with CKD is linked to cardiovascular disease.Objective: To investigate associations between IL-6 and cardiovascular outcomes in patients with chronic coronary syndrome in association with kidney function.Design, Setting, and Participants: This multicenter cohort study included patients enrolled at 663 centers in 39 countries with chronic coronary syndrome who were included in the Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy (STABILITY) trial. Patients were enrolled between December 2008 and April 2010 and were followed up for a median length of 3.7 years. Analysis in this substudy began September 2020.Exposures: Exposures were IL-6 and creatinine estimated glomerular filtration rates (eGFR), which were collected at baseline. Associations between continuous and categorical levels (<2.0 ng/L vs ≥2.0 ng/L) of IL-6 and cardiovascular outcomes were tested in association with eGFR cutoffs (normal eGFR level [≥90 mL/min/1.73 m2], mildly decreased eGFR level [60-90 mL/min/1.73 m2], and moderately to severely decreased eGFR level [<60 mL/min/1.73 m2]).Main Outcomes and Measures: Main outcome was major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, and stroke.Results: This substudy of the STABILITY trial included 14 611 patients with available IL-6 levels at baseline. The median (interquartile range) age was 65 (59-71) years, and 2700 (18.5%) were female. During follow-up, MACE occurred in 1459 individuals (10.0%). Higher levels of IL-6 were in continuous models independently associated with risk of MACE (P < .001) in all CKD strata. Using predefined strata, elevated IL-6 level (≥2.0 vs <2.0 ng/L) was associated with increased risk of MACE at normal kidney function (2.9% vs 1.9% events/y [hazard ratio, 1.35; 95% CI, 1.02-1.78]), mild CKD (3.3% vs 1.9% [hazard ratio, 1.57; 95% CI, 1.35-1.83]), and moderate to severe CKD (5.0% vs 2.9% [hazard ratio, 1.60; 95% CI, 1.28-1.99]).Conclusions and Relevance: In patients with chronic coronary syndrome, elevated levels of IL-6 were associated with risk of MACE in all CKD strata. Thus, IL-6 and CKD stage may help when identifying patients with chronic coronary syndrome for anti-inflammatory treatment.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Ghukasyan, TatevikUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)tatgh570 (författare)
  • Lindbäck, JohanUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper(Swepub:uu)jolin255 (författare)
  • Held, Claes,1956-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi(Swepub:uu)clahe947 (författare)
  • White, Harvey DGreen Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand (författare)
  • Stewart, Ralph A HGreen Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand (författare)
  • Koenig, WolfgangInstitute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany (författare)
  • Cannon, Christopher PCardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts (författare)
  • Budaj, AndrzejDepartment of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland (författare)
  • Hagström, EmilUppsala universitet,Kardiologi(Swepub:uu)emhag677 (författare)
  • Siegbahn, Agneta,1947-Uppsala universitet,Koagulation och inflammationsvetenskap,Kardiologi,UCR(Swepub:uu)agsie424 (författare)
  • Wallentin, Lars,1943-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi(Swepub:uu)larswall (författare)
  • Uppsala universitetUppsala kliniska forskningscentrum (UCR) (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:JAMA cardiology: American Medical Association (AMA)6:12, s. 1440-14452380-65832380-6591

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