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Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes Considerations for Single-Measurement Risk-Stratification Strategies for Myocardial Infarction Using Cardiac Troponin Assays Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction Successful catheter ablation of electrical storm after myocardial infarction Epidemiology and Clinical Outcomes of Patients With Inflammatory Bowel Disease Presenting With Acute Coronary Syndrome In-Hospital Coronary Revascularization Rates and Post-Discharge Mortality Risk in Non–ST-Segment Elevation Acute Coronary Syndrome Open sesame technique in percutaneous coronary intervention for ST-elevation myocardial infarction Complete or Culprit-Only Revascularization for Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis of Randomized Trials Acute Myocardial Injury in Patients Hospitalized With COVID-19 Infection: A Review Universal Definition of Myocardial Infarction
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Original ResearchVolume 74, Issue 6, August 2019

JOURNAL：JACC Cardiovasc Interv. Article Link

Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes

KC, M Hartford, A Ravn-Fischer, E Lorentzen et al. Keywords: acute myocardial infarction; CCL19; CCL21; prognosis; survival; unstable angina pectoris

ABSTRACT

BACKGROUND- The chemokines CCL19 and CCL21 are up-regulated in atherosclerotic disease and heart failure, and increased circulating levels are found in unstable versus stable coronary artery disease.

 

OBJECTIVES- The purpose of this study was to evaluate the prognostic value of CCL19 and CCL21 in acute coronary syndrome (ACS).

 

METHODS- CCL19 and CCL21 levels were analyzed in serum obtained from ACS patients (n = 1,146) on the first morning after hospital admission. Adjustments were made for GRACE (Global Registry of Acute Coronary Events) score, left ventricular ejection fraction, pro–B-type natriuretic peptide, troponin I, and C-reactive protein levels.

 

RESULTS- The major findings were: 1) those having fourth quartile levels of CCL21 on admission of ACS had a significantly higher long-term (median 98 months) risk of major adverse cardiovascular events (MACE) and myocardial infarction in fully adjusted multivariable models; 2) high CCL21 levels at admission were also independently associated with MACE and cardiovascular mortality during short-time (3 months) follow-up; and 3) high CCL19 levels at admission were associated with the development of heart failure.

 

CONCLUSIONS- CCL21 levels are independently associated with outcome after ACS and should be further investigated as a promising biomarker in these patients.

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