细胞因子与冠状动脉疾病（CAD）密切相关，然而，目前关于细胞因子与冠状动脉慢性总闭塞（CTO）的相关性的研究仍然很少。本研究旨在阐明细胞因子与CTO以及其手术结果的关联。共招募了526例疑似CAD但无急性心肌梗死的患者，并根据冠状动脉造影结果将其分为CTO组（n = 122）和非CTO组（n = 404）。此外，还测量了每个患者血清中的12种细胞因子水平[白细胞介素-1β（IL-1β）、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12p70、IL-17、肿瘤坏死因子-α（TNF-α）、干扰素-α（IFN-α）和IFN-γ]。CTO患者男性比例（P=0.001）、吸烟（P=0.014）和糖尿病（P=0.008）发生率较高；IL-6水平（P<0.001）、总甘油三酯（P=0.020）、血清肌酐（P=0.001）和高敏肌钙蛋白I（P=0.001）水平较高；IL-4水平（P<0.001）、总胆固醇（P=0.027）和高密度脂蛋白胆固醇（HDL-C）水平（P<0.001）较低，与无CTO组相比。IL-4（OR=0.216，95%CI:0.135-0.345，P<0.001）、IL-6（OR=1.248，95%CI:1.165-1.337，P<0.001）和HDL-C（OR=0.047，95%CI:0.010-0.221，P<0.001）被鉴定为CTO的独立预测因子。通过结合这三个预测因子，可以获得对CTO的良好预测性能（AUC=0.876），敏感性为81.96%，特异性为81.19%。此外，相较于手术失败患者，手术成功患者的年龄较小（P=0.004），血清IL-6水平较低（P=0.039），并且IL-6水平与手术成功相关（OR=0.962，95%CI: 0.931-0.995，P=0.023）。IL-4、IL-6和HDL-C水平与CTO密切相关，而IL-6还与CTO的手术结果相关。版权所有 © 2023 Hellenic Society of Cardiology。由Elsevier B.V.出版。保留所有权利。

Cytokines are strongly associated with coronary artery disease (CAD); however, few studies have explored the relevance of cytokines in coronary chronic total occlusion (CTO). This study aimed to clarify the association of cytokines with CTO and its procedural outcomes.A total of 526 patients with suspected CAD but not acute myocardial infarction were enrolled and divided into CTO (n = 122) and non-CTO (n = 404) groups based on coronary angiography. Furthermore, serum levels of 12 cytokines [Interleukin-1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, tumor necrosis factor-α (TNF-α), interferon-α (IFN-α), and IFN-γ] were measured for each patient.Patients with CTO had higher rates of male (P=0.001), smoking (P=0.014), and diabetes (P=0.008); higher levels of IL-6 (P<0.001), total triglycerides (P=0.020), serum creatine (P=0.001), and high-sensitivity troponin I (P=0.001); and lower IL-4 (P<0.001), total cholesterol (P=0.027), and high-density lipoprotein cholesterol (HDL-C) (P<0.001) levels compared to those without CTO. IL-4 (OR=0.216, 95%CI:0.135-0.345, P<0.001), IL-6 (OR=1.248, 95%CI:1.165-1.337, P<0.001), and HDL-C (OR=0.047, 95%CI:0.010-0.221, P<0.001) were identified as independent predictors of CTO. And good predictive performance (AUC=0.876) for CTO, with a sensitivity of 81.96% and specificity of 81.19%, could be achieved by combining these three predictors. Furthermore, patients with procedural success had younger age (P=0.004) and lower serum IL-6 levels (P=0.039) compared to those with procedural failure, and IL-6 levels (OR=0.962, 95%CI: 0.931-0.995, P=0.023) were associated with procedural success.IL-4, IL-6, and HDL-C levels were strongly associated with CTO, and IL-6 also linked to procedural outcomes of CTO.Copyright © 2023 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.