C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-α in the prognostic classification of unstable angina pectoris

Koukkunen, Heli; Penttilä, Karri; Kemppainen, Art; Halinen, Matti; Penttilä, Ilkka; Rantanen, Tapio; Pyörälà, Kalevi

doi:10.3109/07853890109002058

Cited by 167 publications

(113 citation statements)

References 35 publications

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“…Their findings are consistent with ours, showing a strong predictive value for the all markers, particularly for IL-6. Similar findings were also reported by Koukkunen et al, 14 exploring the prognostic value of these 3 inflammatory markers in older patients with CHD. Perhaps, especially because of its wide range of actions, including effects on platelets, endothelium, and factors of metabolism and coagulation, IL-6 may have a more important role in the development of CHD than some other inflammatory markers.…”

Section: Discussionsupporting

confidence: 88%

“…5,[7][8][9][10] Moreover, few articles have explored the predictive value of inflammatory markers on cardiovascular events in cardiovascular disease-free subjects, 4,5,7,9,10,12,13 and even fewer have considered multiple markers, such as interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-␣ (TNF-␣), simultaneously. 4,14 In fact, most studies have focused only on CRP. 9 -12,15-18 A recent longitudinal study among elderly subjects without previous myocardial infarction has shown a stronger role for IL-6 in the prediction of congestive heart failure (CHF) than for CRP or TNF-␣.…”

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confidence: 99%

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Inflammatory Markers and Onset of Cardiovascular Events

et al. 2003

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Background— Inflammation plays an important role in cardiovascular disease. The aim of this study is to investigate the predictive value of several inflammatory markers on the incidence of cardiovascular events in well-functioning older persons. Methods and Results— The subjects were 2225 participants 70 to 79 years old, without baseline cardiovascular disease, who were enrolled in the Health, Aging, and Body Composition study. Incident coronary heart disease (CHD), stroke, and congestive heart failure (CHF) events were detected during an average follow-up of 3.6 years. Blood levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) were assessed. After adjustment for potential confounders, IL-6 was significantly associated with all outcomes (CHD events, per IL-6 SD increase: RR, 1.27; 95% CI, 1.10 to 1.48; stroke events, per IL-6 SD increase: RR, 1.45; 95% CI, 1.12 to 1.86; CHF events, per IL-6 SD increase: RR, 1.72; 95% CI, 1.40 to 2.12). TNF-α showed significant associations with CHD (per TNF-α SD increase: RR, 1.22; 95% CI, 1.04 to 1.43) and CHF (per TNF-α SD increase: RR, 1.59; 95% CI, 1.30 to 1.95) events. CRP was significantly associated with CHF events (per CRP SD increase: RR, 1.48; 95% CI, 1.23 to 1.78). A composite summary indicator of inflammation showed a strong association with incident cardiovascular events, with an especially high risk if all 3 inflammatory markers were in the highest tertile. Conclusions— Findings suggest that inflammatory markers are independent predictors of cardiovascular events in older persons.

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Section: Discussionsupporting

confidence: 88%

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confidence: 99%

Inflammatory Markers and Onset of Cardiovascular Events

et al. 2003

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“…TNFa, OX40/OX40L and RANK/ RANKL) and inhibitory (e.g. TRAIL) effects on this process [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Oxidized LDL level is related to gene expression of tumour necrosis factor super family members in children and young adults with familial hypercholesterolaemia

et al. 2012

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Objective. Familial hypercholesterolaemia (FH) is associated with increased risk of premature atherosclerosis. Inflammation is a key event in atherogenesis, and we have previously reported an inflammatory imbalance between tumour necrosis factor (TNF)a and interleukin-10 in children with FH. Based on the potential role of TNF-related molecules in inflammation, we investigated the regulation of other members of the TNF superfamily (TNFSF)/TNF receptor superfamily (TNFRSF) in children and young adults with FH and matched healthy controls.Methods. Expression of TNFSF/TNFRSF genes in peripheral blood mononuclear cells (PBMCs) was quantified in children and young adults with FH prior to (n = 42) and after statin treatment (n = 10) and in controls (n = 25) by quantitative real-time polymerase chain reaction.Results. First we found that, compared with controls, the mRNA levels of OX40L, BAFFR and TRAILR1 were significantly higher, whereas TRAIL and TRAILR3 were significantly lower in children and young adults with FH. Secondly, levels of oxidized low-density lipoprotein (oxLDL) were significantly raised in the FH group, and correlated with the expression of OX40L, BAFFR and TRAILR1. Thirdly, oxLDL increased mRNA levels of BAFFR, TRAILR1 and TRAILR4 in PBMCs ex vivo from individuals with FH. Fourthly, OX40, acting through OX40L, enhanced the oxLDL-induced expression of matrix metalloproteinase-9 in THP-1 monocytes in vitro. Finally, after statin treatment in children with FH (n = 10), mRNA levels of OX40L and TRAILR1 decreased, whereas levels BAFF, TRAIL and TRAILR3 increased.Conclusion. Our findings suggest the involvement of some TNFSF/TNFRSF members and oxLDL in the early stages of atherogenesis; this may potentially contribute to the accelerated rate of atherosclerosis observed in individuals with FH.

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“…We speculate that, also in vivo, elevated TNF-a might enhance cytokine release from monocytes to any LPS-like danger signal (e.g., related to an infection or cellular stress), thereby promoting atherosclerosis. Epidemiological data support the notion that elevated plasma levels of both TNF-a and IL-6 increase the risk of coronary artery disease (Koukkunen et al, 2001;Ridker et al, 2000a). Thus, differential regulation of monocyte-IL-6 production may provide a link from acute inflammatory cytokine release (TNF-a) to the long-term progression of atherosclerotic lesions.…”

Section: Discussionmentioning

confidence: 82%

“…Elevated plasma levels of the two proinflammatory cytokines tumor necrosis factor (TNF)-a and interleukin-6 (IL-6) have been repeatedly associated with increased risk for adverse cardiovascular outcomes (Elkind et al, 2002;Koukkunen et al, 2001;Plutzky, 2001;Ridker et al, 2000a,b;Rohde et al, 1999;Ross, 1999). Inflammatory processes in atherosclerosis are overtly mediated by monocytes which are an important source of circulating cytokines (Plutzky, 2001;Ross, 1999;Vaddi et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Reduced glucocorticoid sensitivity of monocyte interleukin-6 release in male employees with high plasma levels of tumor necrosis factor-α

et al. 2004

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C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-α in the prognostic classification of unstable angina pectoris

Abstract: Elevated levels of acute-phase proteins and cytokines, particularly CRP and IL-6, are strong predictors of the risk of serious coronary events in patients with UAP.

Cited by 167 publications

References 35 publications

Inflammatory Markers and Onset of Cardiovascular Events

Inflammatory Markers and Onset of Cardiovascular Events

Oxidized LDL level is related to gene expression of tumour necrosis factor super family members in children and young adults with familial hypercholesterolaemia

Reduced glucocorticoid sensitivity of monocyte interleukin-6 release in male employees with high plasma levels of tumor necrosis factor-α

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