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Raised Interleukin-10 is an Indicator of Poor Outcome and Enhanced Systemic Inflammation in Patients with Acute Coronary Syndrome
  1. Anders Malarstig (anders.malarstig{at}
  1. Uppsala University, Sweden
    1. Per Eriksson (per.eriksson{at}
    1. Karolinska Institute, Sweden
      1. Anders Hamsten (anders.hamsten{at}
      1. Karolinska Institute, Sweden
        1. Bertil Lindahl (bertil.lindahl{at}
        1. Uppsala University, Sweden
          1. Lars Wallentin (lars.wallentin{at}
          1. Uppsala University, Sweden
            1. Agneta Siegbahn (agneta.siegbahn{at}
            1. Uppsala University, Sweden


              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.

              • acute coronary syndrome
              • biomarker
              • inflammation
              • interleukin-10
              • polymorphism

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