Soluble CXCL16 predicts long-term mortality in acute coronary syndromes.

Abstract

BACKGROUND:

CXCL16/SR-PSOX is an interferon-gamma-regulated chemokine and scavenger receptor for oxidized low-density lipoprotein that is expressed in atherosclerotic lesions. Proteolytic cleavage of membrane-bound CXCL16 releases soluble CXCL16, which may promote migration of effector T cells and augment a proatherogenic inflammatory response. We hypothesized that soluble CXCL16 concentrations are associated with long-term outcome in patients with acute coronary syndromes.

METHODS AND RESULTS:

We assessed the association between circulating CXCL16 levels obtained within 24 hours after admission and time to death in 1351 patients (median age 67 years, 30% female) with a diagnosis of unstable angina, non-ST-segment-elevation myocardial infarction, or ST-segment-elevation myocardial infarction. During a median follow-up time of 81 months, 377 patients died. Increased levels of CXCL16 were prognostically unfavorable; the fourth versus first quartile was associated with higher risk of death (hazard ratio 2.1; 95% CI 1.6 to 2.8; P<0.0001), triple risk of developing heart failure (hazard ratio 3.0; 95% CI 1.8 to 5.1; P<0.0001), and a doubling of the risk of rehospitalization for myocardial infarction (hazard ratio 2.1; 95% CI 1.3 to 3.3; P=0.002). After adjustment for conventional risk markers, logarithmically transformed CXCL16 level remained a strong independent indicator of long-term mortality (hazard ratio 1.21; 95% CI 1.09 to 1.36 per 1 SD increase in CXCL16; P=0.0006) and congestive heart failure development (hazard ratio 1.25; 95% CI 1.05 to 1.48; P=0.01). In a subsample of 714 patients, after further adjustment for troponin T, high-sensitive C-reactive protein, pro-B-type natriuretic peptide, and left ventricular ejection fraction, CXCL16 still provided significant additional prognostic information on mortality (hazard ratio 1.21; 95% CI 1.02 to 1.42 per 1 SD increase in CXCL16; P=0.02).

CONCLUSIONS:

In patients with an acute coronary syndrome, CXCL16 levels obtained within 24 hours of admission are associated with long-term mortality after adjustment for other risk factors.

• Authors: Anna M Jansson, Pål Aukrust, Thor Ueland, Camilla Smith, Torbjørn Omland, Marianne Hartford, Kenneth Caidahl
• Journal: Circulation (Circulation) Vol. 119 Issue 25 Pg. 3181-8 (Jun 30 2009) ISSN: 1524-4539 [Electronic] United States
• PMID: 19528340 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• CXCL16 protein, human
• Chemokine CXCL16
• Chemokines, CXC
• Receptors, Scavenger
• Troponin T
• Natriuretic Peptide, Brain
• C-Reactive Protein

Topics

• Acute Coronary Syndrome (blood, mortality)
• Aged
• Biomarkers
• C-Reactive Protein (metabolism)
• Chemokine CXCL16
• Chemokines, CXC (blood)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (blood, mortality)
• Natriuretic Peptide, Brain (blood)
• Patient Readmission (statistics & numerical data)
• Prognosis
• Proportional Hazards Models
• Receptors, Scavenger (blood)
• Risk Factors
• Solubility
• Troponin T (blood)