Elevated interleukin-6 levels are associated with impaired outcome in cardiac transthyretin amyloidosis

• 作者: Selina J Hein Maximilian Knoll Fabian Aus dem Siepen Jennifer Furkel Stefan Schoenland Ute Hegenbart Hugo A Katus Arnt V Kristen Mathias Konstandin
• 来源期刊: 世界心脏病学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Transthyretin amyloidosis Inflammation Heart failure INTERLEUKIN-6 OUTCOME Risk stratification
• 年，卷（期）: 2021,（3）
• 页码范围: 55-67
• 页数: 13页
• 分类号: R73

摘要

BACKGROUND Elevated interleukin(IL)-6-levels have been described in familial variant transthyretin amyloidosis(ATTRv)associated polyneuropathy and heart failure.However,IL-6 in cardiac ATTR amyloidosis(ATTR-CM)and its prognostic value have not been investigated yet.AIM We aim to study the correlation between IL-6 levels with clinical presentation(Gillmore-class)and outcome[heart transplantation or death(htx/death)],or the combined endpoint of cardiac decompensation or htx/death in ATTR-CM.METHODS IL-6 levels of 106 ATTR-CM patients[54 wild-type ATTRwt,52 ATTRv-CM],15 asymptomatic carriers of ATTR mutations(aATTRv-CM)and 27 healthy donors were quantified using Luminex technology.Statistical analysis was performed using parametric survival regression models.RESULTS We found that IL-6 levels from wild-type ATTR patients were significantly elevated compared to healthy controls,while aATTRv-CM carriers and ATTRv-CM patients did not show a significant difference.IL-6 levels showed significantly higher values in increasing Gillmore classes.Univariate analyses revealed association of low IL-6 levels with cardiac decompensation and htx/death[odds ratio:0.26(0.09-0.72),P=0.01]and htx/death[odds ratio:0.15(0.04-0.58),P=0.006].However,in the multivariate model,no significant improvement of risk prediction was seen for IL-6,while established prognostic factors were significantly associated with outcome.CONCLUSION Raised IL-6 levels correlate with clinical presentation and are associated with worse outcome in ATTR-CM but do not improve stratification in addition to established risk factors.