C-reactive protein, interleukin-6, secretory phospholipase A2 group IIA and intercellular adhesion molecule-1 in the prediction of late outcome events after acute coronary syndromes

J Intern Med. 2007 Nov;262(5):526-36. doi: 10.1111/j.1365-2796.2007.01862.x. Epub 2007 Oct 1.


Objective: We investigated whether levels of C-reactive protein (CRP), interleukin-6 (IL-6), secretory phospholipase A(2) group IIA (sPLA(2)-IIA) and intercellular adhesion molecule-1 (ICAM-I) predict late outcomes in patients with acute coronary syndromes (ACS).

Design: Prospective longitudinal study. CRP (mg L(-1)), IL-6 (pg mL(-1)), sPLA(2)-IIA (ng mL(-1)) and ICAM-1 (ng mL(-1)) were measured at days 1 (n = 757) and 4 (n = 533) after hospital admission for ACS. Their relations to mortality and rehospitalization for myocardial infarction (MI) and congestive heart failure (CHF) were determined.

Setting: Coronary Care Unit at Sahlgrenska University Hospital, Gothenburg, Sweden.

Subjects: Patients with ACS alive at day 30; median follow-up 75 months.

Results: Survival was related to day 1 levels of all markers. After adjustment for confounders, CRP, IL-6 and ICAM-1, but not sPLA(2)-IIA, independently predicted mortality and rehospitalization for CHF. For CRP, the hazard ratio (HR) was 1.3 for mortality (95% confidence interval (CI): 1.1-1.5, P = 0.003) and 1.4 for CHF (95% CI: 1.1-1.9, P = 0.006). For IL-6, HR was 1.3 for mortality (95% CI: 1.1-1.6, P < 0.001) and 1.4 for CHF (95% CI: 1.1-1.8, P = 0.02). For ICAM-1, HR was 1.2 for mortality (95% CI: 1.0-1.4, P = 0.04) and 1.3 for CHF (95% CI: 1.0-1.7, P = 0.03). No marker predicted MI. Marker levels on day 4 provided no additional predictive value.

Conclusions: In patients with ACS, CRP, IL-6, sPLA(2)-IIA and ICAM-1 are associated with long-term mortality and CHF, but not reinfarction. CRP, IL-6 and ICAM-1 provide prognostic information beyond that obtained by clinical variables.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Female
  • Group II Phospholipases A2 / blood*
  • Humans
  • Intercellular Adhesion Molecule-1 / blood*
  • Interleukin-6 / blood*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Readmission
  • Prognosis
  • Prospective Studies
  • Risk Assessment / methods
  • Time Factors


  • Biomarkers
  • Interleukin-6
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein
  • Group II Phospholipases A2