{
  "abstract": "Aims The purpose of this study is to compare the levels of circulating pro-inflammatory cytokines and chemokines in an unselected population undergoing left heart catheterisation and assess if these biomarkers could predict ‘high-risk’ plaque features on optical coherence tomography (OCT) and adverse cardiovascular outcomes.Method and Results In this single centre prospective study, peripheral venous bloods were collected from 62 patients with cardiac chest pain undergoing OCT guided lesion evaluation. Commercially available enzyme-linked immunoassay (ELISA) kits were used to assess expression levels of C-reactive protein, granulocyte colony stimulating factor (CSF), granulocyte-macrophage CSF, interferon-γ, interleukin (IL)-17, IL-18, IL -1α, IL-1β, IL 6, IL 7, IL 8 and tumour necrosis factor α. OCT analysis was undertaken by 2 analysts at a core laboratory. High-risk plaque features were defined as a composite of minimum lumen area (MLA) <3.5 mm 2, lipid arc >180o, presence of macrophages and thin cap fibroatheroma (≤100µm). 6 months post OCT study, patients underwent follow-up for assessment of major adverse cardiovascular event (MACE - composite of new myocardial infarction (MI), cardiac death and ischaemia-driven revascularisation).The median age of our cohort was 62 and 80.6% were men. 11% of the cases were diabetic and 33.8% had previous MI. 67.7% of patients presented with acute coronary syndrome (ACS). 45% of our cohort had negative troponin levels prior to invasive assessment. On OCT assessment, median MLA was 1.9 mm2 and median plaque length was 48 mm. OCT defined high risk plaque features were present in 54.8% of the cases and an acute plaque event was seen in 24.2%. The composite endpoint of MACE at 6 months occurred in 9.6% of patients (n=6). MACE in this group was largely driven by MI (n=3) and repeat revascularisation (n=3). On logistic regression, IL-6 was shown to independently predict high-risk OCT features (OR 1.35, p=0.023) amongst other pro-inflammatory cytokines. In addition to this, IL-6 at its highest quartile (>11.8 pg/ml) was shown to predict MACE independent of baseline characteristics and OCT features (OR 22.7, p=0.029). Area under the curve (AUC) on receiver operating characteristic (ROC) analysis for our predictive model was 0.89.Conclusion IL-6 correlates with high-risk plaque features on OCT and independently predicts MACE in our cohort. This supports the notion that IL-6 levels might help risk stratify patients that require more urgent invasive assessment, while further strengthening the therapeutic utility of targeting IL-6.",
  "authors": [
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Nitin Chandra Mohan"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Georgios Kremastiotis"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Natasha Bryan"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Mark Mariathas"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Gavin Richards"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Ioannis Felekos"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Novalia Sidik"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Julian Strange"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Thomas Johnson"
    },
    {
      "affiliations": [
        "University of Bristol, Bristol, UK"
      ],
      "name": "Jason Johnson"
    }
  ],
  "title": "2-008 Predictive potential of novel biomarkers in invasive management of coronary artery disease",
  "uid": "74d0c4e5-6aac-53ca-aea8-40b1232c9e4e"
}