Objective: To re-evaluate the relationship between plasma IL-10 concentration at hospital admission and outcome and to investigate the impact of single nucleotide polymorphisms (SNP) in the IL10 gene in patients with non-ST elevation acute coronary syndrome (ACS).
Design: Determination of IL-10 plasma concentrations and genotyping of SNPs in the IL10 gene in a prospective trial of patients with ACS and in a group of healthy controls.
Patients: 3179 patients in the Fragmin and Fast Revascularisation During Instability in Coronary Artery Disease II trial and 397 healthy controls.
Main outcome measures: Mortality and incidence of myocardial infarction at 12 months.
Results: The median and interquartile ranges of IL-10 were 0.8 (0.5 - 1.0) pg/ml in healthy controls and 1.1 (0.7 - 1.9) pg/ml in patients (p<0.001). In patients, IL-10 predicted a crude risk increase of death/MI, with the highest risk observed in the fourth quartile (1.7 (1.2 - 2.3) (adjusted odds ratio, 95 % confidence interval). Adjustment for common risk indicators, including c-reactive protein and interleukin-6, weakened the association to a non-significant level. The 1170 CC genotype weakly predicted increased plasma concentrations of IL-10 in patients (p=0.04) and in controls (p=0.03), which was consistent with the modest association of this allelic variant with coronary disease (p=0.01).
Conclusion: In contrast with some previous reports, we conclude that IL-10 reflects a pro-inflammatory state in patients with ACS and therefore suggest that IL-10 is an equally effective biomarker for the risk prediction of future cardiovascular events as other markers of systemic inflammation.
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