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Interleukin-18 as a Predictor of Future Events in Patients With Acute Coronary Syndromes.

Journal article
Authors Marianne Hartford
Olov Wiklund
Lillemor Mattsson Hultén
Anita Persson
Thomas Karlsson
Johan Herlitz
Johannes Hulthe
Kenneth Caidahl
Published in Arteriosclerosis, thrombosis, and vascular biology
Volume 30
Issue 10
Pages 2039-2046
ISSN 1524-4636
Publication year 2010
Published at Wallenberg Laboratory
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 2039-2046
Language en
Keywords acute coronary syndromes, atherosclerosis, C-reactive protein, interleukin-18, prognosis
Subject categories Cardiac and Cardiovascular Systems


OBJECTIVE: The aim of this study was to assess the short- and long-term prognostic significance of interleukin-18 (IL-18) levels in patients with acute coronary syndromes (ACS). METHODS AND RESULTS: In patients hospitalized with ACS (median age, 66 years; 30% females), we evaluated associations of serum IL-18 levels from day 1 (n=1261) with the short- (<3 months) and long-term (median, 7.6 years) risk of death, development of congestive heart failure (CHF), and myocardial infarction (MI). IL-18 was not significantly associated with short-term mortality. In the long term, IL-18 levels were significantly related to all-cause mortality, even after adjustment for clinical confounders (hazard ratio [HR], 1.19; 95% confidence interval, 1.07 to 1.33; P=0.002). Long-term, cardiovascular mortality was univariately related to IL-18, and the adjusted relation between noncardiovascular mortality and IL-18 was highly significant (HR, 1.36; 95% confidence interval, 1.11 to 1.67; P=0.003). IL-18 independently predicted CHF, MI, and cardiovascular death/CHF/MI in both the short and long term. Measurements from day 1 of ACS and 3 months after ACS had a similar power to predict late outcome. CONCLUSIONS: The addition of the measurement of IL-18 to clinical variables improved the prediction of risk of all-cause and noncardiovascular mortality. The association between IL-18 and noncardiovascular mortality is intriguing and warrants further study.

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