Two inflammatory markers independently predict heart disease risk
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Key takeaways:
- Data show low levels of interleukin-4 and interleukin-17 are associated with coronary artery disease.
- The markers could potentially serve as a diagnostic tool to guide patient referral for angiography.
Among adults presenting with chest pain, those with CAD confirmed by angiography had significantly lower levels of the cytokines interleukin-4 and interleukin-17 compared with those without CAD, data show.
“The role of interleukin‐4 (IL-4) and interleukin‐17 (IL‐17) in disease progression and plaque stability is currently a topic of debate, with some studies suggesting a proatherogenic effect, while others propose an atheroprotective role,” Chengqian Yin, PhD, of the Center for Coronary Heart Disease at Beijing Anzhen Hospital and Capital Medical University, China, wrote in Clinical Cardiology. “Efforts to develop anti‐inflammatory treatments for atherosclerosis by targeting various proinflammatory cytokines and antiatherosclerosis antibodies have made significant progress in recent years.”
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Yin and colleagues analyzed data from 487 adults who underwent coronary angiography due to suspected CAD but did not have acute MI. Within the cohort, 101 patients who presented with chest pain had normal or less severe stenosis on angiography ( 50%), whereas 386 patients had CAD, or severe stenosis (> 50%) in at least one major coronary artery. Researchers measured multiple inflammatory markers for patients in the CAD and non-CAD groups before undergoing angiography, including IL‐1beta, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, tumor necrosis factor‐alpha, interferon (IFN)-alpha and IFN‐gamma.
Researchers found that patients with confirmed CAD had lower levels of IL‐4 (P < .001), IL‐12p70 (P = .004), IL‐17 (P = .001), IFN‐alpha (P = .003) and IFN‐gamma (P = .011), while having a higher level of IL‐8 (P = .039) compared with patients without CAD.
In logistic regression analysis, IL‐4 (OR = 0.534; 95% CI, 0.385-0.741) and IL‐17 (OR = 0.914; 95% CI, 0.863-0.967) independently predicted CAD, as did low HDL (OR = 0.148; 95% CI, 0.051-0.433), male sex (OR = 2.296; 95% CI, 1.281-4.115), smoking (OR = 2.272; 95% CI, 1.151-4.485) and diabetes (OR = 2.643; 95% CI, 1.313-5.321).
The area under receiver operating characteristic curve was 0.677 for IL-4 (95% CI, 0.62-0.732), 0.64 for IL-17 (95% CI, 0.582-0.698) and 0.725 for HDL (95% CI, 0.672-0.779). Researchers then combined IL-4, IL-17 and HDL for an AUC of 0.791 (95% CI, 0.749-0.832).
“Our study found that serum IL‐4 and IL‐17 levels were significantly associated with the presence of CAD,” the researchers wrote. “The risk prediction model constructed by combining these serum cytokines with other clinical risk factors such as gender, smoking, diabetes and HDL has the potential to identify individuals with CAD among those who have suspected CAD but not acute MI. This model could serve as a cost‐effective and low‐risk diagnostic tool to guide the referral of symptomatic patients for angiography, especially in resource‐limited settings.”
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