Inflammatory cytokines at admission--independent prognostic markers in patients with acute coronary syndrome and hyperglycaemia

Acute Card Care. 2012 Mar;14(1):13-9. doi: 10.3109/17482941.2011.655292.

Abstract

Background: The clinical significance of inflammatory cytokines as independent prognostic markers in patients with acute coronary syndrome (ACS) and hyperglycaemia remains uncertain.

Aim: To determine the value of inflammatory biomarkers as independent prognostic indicators and their relation with hyperglycaemia in ACS patients.

Methods: TNF-α and hsCRP were defined 48 h after admission and indicators for hyperglycaemia were calculated in 256 consecutive patients with ACS. A correlation analysis with standard clinical variables--EF, maximum CK, CK-MB, troponin and different indices for hyperglycaemia was performed. Patients were followed up for 12 months.

Results: Baseline TNF-α correlated neither to EF, nor to the enzymes for myocardial necrosis (P>0.05). In contrast, hsCRP correlated negatively with EF (P=0.001) and positively with maximum CK, CK-MB, troponin (P=0.0001) irrespectively of the glucose status. TNF-α was associated with fasting glycaemia, HGI and TAG (P=0.033/0.041/0.018) and hsCRP-with indicators for acute, persistent and chronic glycaemia in all patients. Moreover, hsCRP was an independent marker for six-month survival (P=0.024). TAG was a stronger six-month survival predictor than hsCRP (P=0.010/0.024).

Conclusion: hsCRP and TNF-α have clinical significance regardless of the glucose metabolic status. hsCRP is an independent marker for six-month survival. TAG is the better predictor for poor outcome than hsCRP.

MeSH terms

  • Acute Coronary Syndrome / physiopathology*
  • Aged
  • Biomarkers / analysis
  • Blood Glucose / metabolism
  • Bulgaria
  • C-Reactive Protein / analysis*
  • Creatine Kinase, MB Form / analysis
  • Cytokines / analysis*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperglycemia / blood*
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology*
  • Myocardium / chemistry*
  • Prognosis
  • Troponin T / analysis
  • Tumor Necrosis Factor-alpha / analysis*

Substances

  • Biomarkers
  • Blood Glucose
  • Cytokines
  • Troponin T
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • Creatine Kinase, MB Form