Prognostic significance of plasma concentrations of transforming growth factor-β in patients with coronary artery disease

Abstract
Cytokines play an important role in modulating inflammatory and proliferative responses, including atherosclerosis. Transforming growth factor-β (TGF-β) and macrophage-colony stimulating factor (M-CSF) are one of the major antiinflammatory and proinflammatory cytokines, respectively. We have previously demonstrated that plasma concentrations of TGF-β are decreased while those of M-CSF are increased in patients with coronary artery disease (CAD). In this study, we examined whether those alterations in plasma levels of cytokines have a prognostic significance in patients with CAD. Sixty-eight consecutive patients with proven CAD were studied. The plasma concentrations of TGF-β and those of M-CSF were measured by enzyme-linked immunosorbent assay (ELISA). They were divided into groups: high (≥6 ng/ml, n = 19) and low (500 ng/ml, n = 52) and low (≤500 ng/ml, n = 16) M-CSF groups. The long-term prognosis of these patients was prospectively followed up for a mean period of 979 ± 27 days. The prognosis was analyzed by Kaplan–Meier analysis in terms of total survival, survival without myocardial infarction, survival without cardiovascular events and survival without coronary interventions. The analysis showed that the low TGF-β group had a significantly poor prognosis in terms of survival without cardiovascular events and survival without coronary interventions as compared with the high TGF-β group (both P < 0.05), while other prognoses were comparable between the two groups. By contrast, no significant prognostic influence was noted regarding M-CSF. These results suggest that plasma concentrations of TGF-β may have a prognostic significance in patients with CAD.