Studies Of Association Between Interleukin-18and GRACE Score In Patients With Acute Coronary Syndrome

Objective:To study the relationship between interleukin-18(IL-18) level and global registry of acute coronary events (GRACE) risk score as well as risk stratification in patients with Acute coronary syndrome(ACS). To investigate the clinical prognostic value of IL-18for major adverse cardiac events (MACE) in acute coronary syndrome (ACS) patients.Methods:A total of150ACS patients admitted in our hospital between April2012and January2013were included [50patients with unstable angina(UA),50patients with non-ST-segment elevation myocardial infarction (NSTEMI) and50patients with ST-segment elevation myocardial infarction (STEMI)]. Plasma IL-18was measured by enzyme-linked immunosorbent assay(ELISA). Coronary heart disease were give conventional treatments and MACE was recorded. The GRACE risk score was used for risk assessment. Analyze the relationship between IL-18level and GRACE risk score as well as risk stratification in patients with ACS.Result:According to GRACE risk stratification, IL-18was the highest in the high risk group (P<0.05). IL-18was higher in middle risk group than in low risk group (P<0.05). According IL-18level, patients were stratified into four groups by quartile. Compared with the lowest, second, and third quartiles. The GRACE risk score was the highest in the fourth quartile (P<0.05). Patients with IL-18level above the75percentile had higher ratio of high risk than patients with IL-18under the75percentile (P<0.05). The IL-18level in ACS patients was positively related with GRACE risk score(r=0.564, P<0.05). MACE occurred in12[8.0%(12/150)] patients during hospitalization. ROC analysis showed AUC of on admission IL-18was0.887(SE=0.034P=0.001,95%CI0.821～0.954).and AUC of GRACE risk score was0.914(SE=0.033P=0.001,95%CI0.849～0.979) for predicting the short-term risk of MACE.Conclusion:IL-18level is positively related with GRACE risk score. Both IL-18level and GRACE risk score are valuable parameters for risk stratification in patients with ACS. Increased IL-18level and GRACE risk score are predictors for increased short-term risk of MACE.