Inflammatory cytokines at admission—Independent prognostic markers in patients with acute coronary syndrome and hyperglycaemia

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.

Keywords::

• Inflammatory cytokines
• hyperglycaemia
• surrogate marker
• prognosis

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.