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首页> 外文期刊>Research Reports in Clinical Cardiology >Periprocedural myocardial infarction enhances the predictive value of inflammatory biomarkers for patients with obstructive coronary artery disease after implantation of drug-eluting stent
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Periprocedural myocardial infarction enhances the predictive value of inflammatory biomarkers for patients with obstructive coronary artery disease after implantation of drug-eluting stent

机译：围手术期心肌梗死增强了药物洗脱支架植入后对阻塞性冠状动脉疾病患者炎性生物标志物的预测价值

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Objective: The present study aims to clarify the long-term clinical importance of interleukin (IL)-6 in predicting major adverse cardiac events (MACE) for an entire cohort of patients with coronary artery disease after implantation of a drug-eluting stent (DES), and its interplay with periprocedural myocardial infarction (PMI). Background: The correlation of proinflammatory biomarkers with occurrence of clinical events, including PMI and mortality, is controversial. Methods: IL-6 was measured in 1,991 patients at admission. The participants were then assigned to two groups: IL-6 level ≥9 pg/mL and IL-6 level <9 pg/mL. The primary endpoint was the occurrence of cardiac death or myocardial infarction (MI) at year 3 after indexed percutaneous coronary intervention (PCI) procedure. Results: The in-hospital rate of the primary endpoint in the IL-6 level ≥9 pg/mL group was 9.1%, statistically significantly different to 6.3% in the IL-6 <9 pg/mL group (P=0.026), mainly driven by the increased rate of MI (9.1% vs 6.1%, P=0.025). Those differences in MI/death and MI was sustained through to the 3-year follow-up (10.9% vs 7.6%, P=0.017 and 10.1% vs 7.5%, P=0.049). At the 3-year follow-up after the assigned procedure, more frequent MI was also the main reason for increased composite MACE between the IL-6 ≥9 pg/mL and IL-6 <9 pg/mL groups (20.7% vs 15.8%, P=0.007). In the IL-6 ≥9 pg/mL group, PMI was strongly correlated with mortality at 1-year through to the 3-year (hazard ratio: 2.96, 95% confidence interval: 1.35–6.49, P=0.005) follow-up after PCI procedure. Conclusion: Elevated preprocedural serum IL-6 level was correlated with death, MI, and MACE after implantation of the DES. PMI enhances the predictive value of IL-6 for post-DES events.
机译：目的：本研究旨在阐明白介素（IL）-6在预测整个药物冠状动脉疾病患者队列中的主要不良心脏事件（MACE）植入后的长期临床重要性（DES） ），以及与围手术期心肌梗死（PMI）的相互作用。背景：促炎生物标志物与包括PMI和死亡率在内的临床事件的发生之间的相关性存在争议。方法：在入院时对1,991例患者进行了IL-6测定。然后将参与者分为两组：IL-6水平≥9pg / mL和IL-6水平<9 pg / mL。主要终点是经皮冠状动脉介入治疗（PCI）术后第3年发生心源性死亡或心肌梗塞（MI）。结果：IL-6≥9 pg / mL组主要终点的住院率为9.1％，与IL-6 <9 pg / mL组的6.3％相比有统计学差异（P = 0.026），主要是由心梗率增加所致（9.1％比6.1％，P = 0.025）。 MI /死亡和MI的差异一直持续到3年随访（10.9％比7.6％，P = 0.017; 10.1％比7.5％，P = 0.049）。在指定程序后的三年随访中，IL-6≥9pg / mL和IL-6 <9 pg / mL组之间更频繁的MI也是复合MACE增加的主要原因（20.7％vs 15.8） ％，P = 0.007）。在IL-6≥9pg / mL组中，PMI与1年至3年死亡率密切相关（危险比：2.96，95％置信区间：1.35-6.49，P = 0.005）在PCI程序之后。结论：DES植入后，术前血清IL-6水平升高与死亡，MI和MACE相关。 PMI增强了IL-6对DES后事件的预测价值。

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