Association of serum cytokines with coronary chronic total occlusion and their role in predicting procedural outcomes

Background

Cytokines are strongly associated with coronary artery disease (CAD); however, few studies have explored the relevance of cytokines in coronary chronic total occlusion (CTO). This study aimed to clarify the association of cytokines with CTO and its procedural outcomes.

Methods

A total of 526 patients with suspected CAD but not acute myocardial infarction were enrolled and divided into CTO (n = 122) and non–CTO (n = 404) groups based on coronary angiography. Furthermore, serum levels of 12 cytokines [Interleukin–1β (IL–1β), IL–2, IL–4, IL–5, IL–6, IL–8, IL–10, IL–12p70, IL–17, tumor necrosis factor–α (TNF–α), interferon–α (IFN–α), and IFN–γ] were measured for each patient.

Results

Patients with CTO had higher rates of male (P = 0.001), smoking (P = 0.014), and diabetes (P = 0.008); higher levels of IL–6 (P < 0.001), total triglycerides (P = 0.020), serum creatine (P = 0.001), and high–sensitivity troponin I (P = 0.001); and lower IL–4 (P < 0.001), total cholesterol (P = 0.027), and high–density lipoprotein cholesterol (HDL–C) (P < 0.001) levels compared to those without CTO. IL–4 (OR = 0.216, 95%CI:0.135–0.345, P < 0.001), IL–6 (OR = 1.248, 95%CI:1.165–1.337, P < 0.001), and HDL–C (OR = 0.047, 95%CI:0.010–0.221, P < 0.001) were identified as independent predictors of CTO. And good predictive performance (AUC = 0.876) for CTO, with a sensitivity of 81.96% and specificity of 81.19%, could be achieved by combining these three predictors. Furthermore, patients with procedural success had younger age (P = 0.004) and lower serum IL-6 levels (P = 0.039) compared to those with procedural failure, and IL-6 levels (OR = 0.962, 95%CI: 0.931-0.995, P = 0.023) were associated with procedural success.

Conclusion

IL–4, IL–6, and HDL–C levels were strongly associated with CTO, and IL–6 also linked to procedural outcomes of CTO.