Abstract 2609: Soluble CXCL16 and Risk of Future Morbidity in Acute Coronary Syndromes
Background: CXCL16 is a transmembrane molecule acting as a scavenger receptor for oxidized LDL. It can be cleaved off from the cell surface to become a soluble chemoattractant, generating an inflammatory response in the vascular bed. We have previously described a correlation between soluble CXCL16 concentrations and long-term mortality (featured in fig. 1). In this study, we sought to assess the relationship between CXCL16 levels and the risk of developing future cardiovascular morbidity.
Methods: 1351 patients (30 % female, median age 67 years, interquartile range 58 –73 years) admitted to a teaching hospital with a diagnosis of unstable angina, ST-elevation- or non-ST-elevation myocardial infarction had blood drawn for CXCL16 analysis within 24 hours of admission. Hospital records were used to identify rehospitalization due to myocardial infarction, stroke and heart failure. The association between CXCL16 concentrations and events was calculated using a Cox proportional hazards regression model.
Results: During a median follow-up time of 49 months (interquartile range 32– 65), 175 patients were rehospitalized due to myocardial infarction, 76 patients due to stroke and 142 patients due to heart failure. Patients with CXCL16 in the 4th quartile were three times as likely as those with CXCL16 in the 1st quartile to become hospitalized due to heart failure and twice as likely to be hospitalized due to myocardial infarction and stroke during follow-up. The results remained significant for heart failure and borderline for myocardial infarction, but were not significant for stroke after adjustment for age, gender, previous MI, previous angina, previous CHF, previous diabetes, previous hypertension, current smoking, index diagnosis, heart rate, peak CKMB, creatinine clearance and Killip class (>I)
Conclusions: In patients with acute coronary syndromes, CXCL16 predicts future hospitalizations due to heart failure and possibly also myocardial infarction.