Euro Heart Failure:白细胞介素-6在心力衰竭中的临床意义

2019-08-11 不详 MedSci原创

炎症是心力衰竭(HF)的病理生理学中的关键过程,但针对炎症通路中的关键因子抗肿瘤坏死因子(TNF)-α的靶向治疗在很大程度上是不成功的。白细胞介素(IL)-6是重要的炎症介质,可能构成HF的潜在药理学靶点。然而,关于IL-6与HF中的临床特征,结果和其他炎症生物标志物之间的关联知之甚少。因此,本项研究旨在确定IL-6与心力衰竭的关系。

背景及目标:
炎症是心力衰竭(HF)的病理生理学中的关键过程,但针对炎症通路中的关键因子抗肿瘤坏死因子(TNF)-α的靶向治疗在很大程度上是不成功的。白细胞介素(IL)-6是重要的炎症介质,可能构成HF的潜在药理学靶点。然而,关于IL-6与HF中的临床特征,结果和其他炎症生物标志物之间的关联知之甚少。因此,本项研究旨在确定IL-6与心力衰竭的关系。

方法
研究人员对BIOSTAT-CHF研究中的2329名患者[左心室射血分数(LVEF)≤40%的患者占有89.4%]中测量白细胞介素-6。主要观察结果是2年内全因死亡率和HF住院治疗率,其中全因,心血管(CV)和非CV死亡事件为次要结果。

结果:
所有纳入患者中大约一半(56%)的血浆IL-6值大于先前确定的基线正常值的第95百分位数。升高的N末端脑钠尿肽,降钙素原和铁调素,年龄较小,TNF-α/ IL-1相关生物标志物,或铁缺乏,心房颤动和LVEF> 40%均与IL-6水平升高独立相关。IL-6与全因死亡率[1.22(1.16-1.29),P<0.001]和CV以及非CV死亡率[1.16(1.09-1.24),P<0.001; 1.31(1.18-1.45),P<0.001]均独立相关。

结论:
在HF患者中,超过50%的患者的IL-6水平升高,并且与铁缺乏,LVEF降低,心房颤动和临床结果较差有关。这些发现值得进一步研究IL-6是否可以作为特定HF亚群的潜在治疗靶点。

原始出处:
George Markousis-Mavrogenis. Et al. The clinical significance of interleukin‐6 in heart failure: results from the BIOSTAT‐CHF study. European journal of Heart Failure.2019.

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    2020-06-10 amy0550
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    2019-08-13 zhaojie88
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    2019-08-13 slcumt
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    2019-08-11 天地飞扬

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    2019-08-11 天地飞扬

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