(Circulation. 2001;103:2260.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Interleukin-6 (IL-6) and the Prognosis of Abdominal Aortic Aneurysms
From the Department of Vascular Surgery, Imperial College at Charing Cross Hospital (K.G.J., L.C.B., M.S., R.M.G., J.T.P.), and the Department of Cardiovascular Genetics, Rayne Institute (D.J.B., S.E.H.), London, UK.
Correspondence to Professor J.T. Powell, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry CV2 2DX, UK. E-mail janet.powell{at}wh-tr.wmids.nhs.uk
Background—Abdominal aortic aneurysm is a multifactorial disorder in which inflammation is an important pathophysiological feature. In explant culture, aneurysm biopsies secrete large amounts of interleukin-6 (IL-6), and among aneurysm patients, the circulating concentration of IL-6 appears to be increased.
Methods and Results—We
investigated, in 19 patients, whether aneurysm wall was an
important source of circulating IL-6. We also tested the hypotheses, in
466 patients with a small aneurysm, that (1) high
concentrations of circulating IL-6 signaled rapid aneurysm
growth and (2) the -174 G
C polymorphism in the
IL-6 promoter predicted
survival. For 19 patients with large or inflammatory aneurysms,
the concentration of IL-6 was higher in the iliac arteries than the
brachial arteries (median difference 26.5 pg/mL, this difference
increasing with aneurysm diameter,
P=0.01). In 466 patients with
small aneurysms, the frequency of the -174 C allele
(0.40) was similar to that in a normal healthy population. Patients of
GG genotype had lower plasma concentrations of IL-6 than
patients of GC and CC genotypes (medians 1.9, 4.8, and 15.6
pg/mL, respectively, Kruskal-Wallis
P=0.047).
Cardiovascular and all-cause mortalities were lower for
patients of GG genotype than for patients of GC and CC
genotype: hazard ratios 0.32 (95% CI 0.12 to 0.93),
P=0.036, and 0.51 (95% CI 0.25
to 1.00), P=0.05, respectively.
There was no association between plasma IL-6 or
IL-6 genotype and
aneurysm growth.
Conclusions—Aortic
aneurysms appear to be an important source of circulating IL-6,
the concentration being influenced by genotype. For patients
with small aneurysms, the -174 GC
IL-6 genotype predicts
future cardiovascular
mortality.
Key Words: aneurysm • survival • interleukins • genetics
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