Author + information
- Received January 12, 2019
- Revision received April 5, 2019
- Accepted June 5, 2019
- Published online August 5, 2019.
- Kenneth Caidahl, MD, PhDa,b,c,
- Marianne Hartford, MD, PhDa,
- Annica Ravn-Fischer, MD, PhDa,d,
- Erik Lorentzen, MD, PhDe,
- Arne Yndestad, PhDf,g,
- Thomas Karlsson, BSch,
- Pål Aukrust, MD, PhDd,g,i,j and
- Thor Ueland, PhDf,i,k,∗ (, )@ThorUeland
- aDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- bDepartment of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- cDepartments of Molecular Medicine and Surgery and Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- dResearch Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- eBioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- fResearch Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- gK.G. Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway
- hHealth Metrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- iFaculty of Medicine, University of Oslo, Oslo, Norway
- jSection of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
- kK.G. Jebsen–Thrombosis Research and Expertise Center (TREC), University of Tromsø, Tromsø, Norway
- ↵∗Address for correspondence:
Prof. Thor Ueland, Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, P.B. 4959 Nydalen, 0424 Oslo, Norway.
Background The chemokines CCL19 and CCL21 are up-regulated in atherosclerotic disease and heart failure, and increased circulating levels are found in unstable versus stable coronary artery disease.
Objectives The purpose of this study was to evaluate the prognostic value of CCL19 and CCL21 in acute coronary syndrome (ACS).
Methods CCL19 and CCL21 levels were analyzed in serum obtained from ACS patients (n = 1,146) on the first morning after hospital admission. Adjustments were made for GRACE (Global Registry of Acute Coronary Events) score, left ventricular ejection fraction, pro–B-type natriuretic peptide, troponin I, and C-reactive protein levels.
Results The major findings were: 1) those having fourth quartile levels of CCL21 on admission of ACS had a significantly higher long-term (median 98 months) risk of major adverse cardiovascular events (MACE) and myocardial infarction in fully adjusted multivariable models; 2) high CCL21 levels at admission were also independently associated with MACE and cardiovascular mortality during short-time (3 months) follow-up; and 3) high CCL19 levels at admission were associated with the development of heart failure.
Conclusions CCL21 levels are independently associated with outcome after ACS and should be further investigated as a promising biomarker in these patients.
This research was supported by the Swedish Research Council (Project Grant K2012-65X-22036-01-3), the Swedish Heart-Lung Foundation (Project Grants 20120209, 20150423, and 20170669), the Västra Götaland Region, grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (Project Grants ALFGBG-140341, 447561, 726481, and 824851). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received January 12, 2019.
- Revision received April 5, 2019.
- Accepted June 5, 2019.
- 2019 American College of Cardiology Foundation
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