Additive prognostic value of interleukin-6 at peak phase of dobutamine stress echocardiography in patients with coronary artery disease. A 6-year follow-up study

Ikonomidis, Ignatios; Athanassopoulos, George; Stamatelopoulos, Kimon; Lekakis, John; Revela, Ioanna; Venetsanou, Kiriaki; Marinou, Margarita; Monaco, Claudia; Cokkinos, Dennis V.; Nihoyannopoulos, Petros

doi:10.1016/j.ahj.2008.03.020

« Previous Next »American Heart Journal
Volume 156, Issue 2 , Pages 269-276, August 2008

Additive prognostic value of interleukin-6 at peak phase of dobutamine stress echocardiography in patients with coronary artery disease. A 6-year follow-up study

Ignatios Ikonomidis, MD
- 2nd Cardiology Department, Attikon Hospital, University of Athens, Athens, Greece
- Reprint requests: Ignatios Ikonomidis, MD, 2nd Cardiology Department, Attikon Hospital, University of Athens, Perikleous 19, Athens 14343, Greece.
George Athanassopoulos, MD
- 1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
Kimon Stamatelopoulos, MD
- Department of Cardiology, Hammersmith Hospital, The Imperial College School of Medicine, London, UK
John Lekakis, MD
- 2nd Cardiology Department, Attikon Hospital, University of Athens, Athens, Greece
Ioanna Revela, MD
- 2nd Cardiology Department, Attikon Hospital, University of Athens, Athens, Greece
Kiriaki Venetsanou, MD
- 2nd Cardiology Department, Attikon Hospital, University of Athens, Athens, Greece
Margarita Marinou, MD
- 1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
Claudia Monaco, MD
- Department of Cardiology, Hammersmith Hospital, The Imperial College School of Medicine, London, UK
Dennis V. Cokkinos, MD
- 1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
Petros Nihoyannopoulos, MD
- Department of Cardiology, Hammersmith Hospital, The Imperial College School of Medicine, London, UK

Received 22 January 2008; accepted 20 March 2008.

Background

Interleukin-6 (IL-6) and tissue factor (TF) are elevated after myocardial ischemia during dobutamine stress echo (DSE). We examined the incremental prognostic value of IL-6 or TF measured during DSE over echocardiographic and clinical factors in patients with chronic coronary artery disease (CAD).

Methods

We studied 106 patients with angiographically documented CAD. IL-6 and TF were measured at rest, peak, and during recovery. A wall motion score index was calculated.

Results

Fifty-seven (54%) patients had ischemia at DSE. During follow-up (63.7 ± 20 months), 36 patients (33%) had an adverse event (12 cardiac deaths, 24 acute coronary events). Patients with events had a higher peak IL-6 (P = .02) but similar rest and recovery IL-6 than those without. Patients with peak IL-6 ≥3.14 pg/mL (upper tertile) had a hazard ratio of 2.7 (95% CI 1.44-5.37) (P < .01 for an adverse event). The addition of peak wall motion score index in a multivariable model including risk factors, ejection fraction, revascularization, and multivessel disease increased the model's c statistic from 0.66 to 0.70 (P = .04). The addition of peak IL-6 further increased the model's c statistic to 0.75 (P = .04). Tissue factor was not related with cardiac events.