Summary: | Background: Interest to evaluate the prognostic value of the inflammatory marker, IL-6 in young patients with ACS.
Methods: 140 young patients (18–40 years old) with ACS, were included in this non-randomized prospective study. They were subjected to (a) full clinical evaluation (b) Laboratory evaluation (c) Standard 12 leads ECG and Echocardiography and (d) coronary angiography. The patients were divided into two groups, those with acute chest pain and positive coronary angiography (110 patients), and those with acute chest pain but with normal coronary angiography (control group, 30 patients).
Results: The IL-6 level was significantly higher in patients with documented CAD compared to the control group (39.56 ± 2.5 Vs 3.83 ± 0.79 P < 0.001). IL-6 level was significantly higher in patients with significant lesions who needed to perform PCI (92 patients) than patients with non-significant atherosclerotic plaques needing just medical treatment (18 patients) (45.5 ± 23.17 Vs 9.22 ± 1.93 P < 0.001). Higher level of IL-6 in STEMI patients (63 Patients 57%) than NSTEMI (23 Patients 21%) and UA (24 Patients 22%) (49.56 ± 23 Vs 43.5 ± 17 Vs 9.5 ± 2.53 respectively with P < 0.001) was observed. The optimal cutoff value for IL-6 level to predict morbidity was 41 pg/ml with a sensitivity of 100%, specificity of 66%, and positive predictive value of 25%, negative predictive value of 100% and the diagnostic accuracy of 69%.
Conclusion: The use of IL-6 as a prognostic marker for ACS may be of Value; it may predict the severity of CAD as well as the mortality and morbidity of young patients with acute coronary syndrome.
|