Abstract 15489: Circulating Levels of Interleukin-17 and Cardiovascular Outcomes in Patients with Acute Myocardial Infarction

Abstract

Aim: IL-17 pathway is being clinically targeted in immune-mediated diseases, most of which are associated with a significant cardiovascular risk.We investigated the relationship between serum levels of IL-17 and the risk of cardiovascular events in patients with acute myocardial infarction.

Methods and Results: We used data from 981patients enrolled in the prospective, multicenter French registry of Acute ST elevation or non-ST-elevation Myocardial Infarction Serum levels of IL-17 were associated with the risk of all-cause death and recurrent MI at two years, with levels of IL-17 below the median indicative of a worse outcome. The impact of IL-17 remained significant after adjustment for known cardiovascular risk factors, CRP, and treatments including statins: Hazard ratio (HR)=1.40 (1.03-1.91);P=0.03. IL-17 inhibites mononuclear cell adhesion to endothelium and reduces endothelial VCAM-1 expression. Patientswith low (below the median) IL-17 levels and high (above the median) soluble VCAM-1 (sVCAM-1) levels were at particularly increased risk of death and MI: adjusted HR=2.22 (1.32-3.75) compared with the high IL-17/low sVCAM-1 group (P=0.002).

Conclusions: Low serum levels of IL-17 are associated with a higher risk of major cardiovascular events in Caucasian patients with acute MI. Ourfindings suggest that patients included in trials using IL17 inhibitors, particularly those with identifiable cardiovascular risk factors, may be at potentially higher risk of serious cardiovascular events and should therefore be closely monitored.