Abstract | Importance: 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: 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.
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Authors | Gorav Batra, Tatevik Ghukasyan Lakic, Johan Lindbäck, Claes Held, Harvey D White, Ralph A H Stewart, Wolfgang Koenig, Christopher P Cannon, Andrzej Budaj, Emil Hagström, Agneta Siegbahn, Lars Wallentin, STABILITY Investigators |
Journal | JAMA cardiology
(JAMA Cardiol)
Vol. 6
Issue 12
Pg. 1440-1445
(12 01 2021)
ISSN: 2380-6591 [Electronic] United States |
PMID | 34431970
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Benzaldehydes
- Biomarkers
- Interleukin-6
- Oximes
- Phospholipase A2 Inhibitors
- darapladib
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Topics |
- Aged
- Benzaldehydes
(therapeutic use)
- Biomarkers
(blood)
- Coronary Artery Disease
(blood, complications, drug therapy)
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
(physiology)
- Humans
- Interleukin-6
(blood)
- Male
- Middle Aged
- Oximes
(therapeutic use)
- Phospholipase A2 Inhibitors
(therapeutic use)
- Prognosis
- Renal Insufficiency, Chronic
(blood, complications, physiopathology)
- Retrospective Studies
- Risk Factors
- Syndrome
- Time Factors
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