Interleukin-1 receptor antagonist levels correlate with extent of myocardial loss in patients with acute myocardial infarction.
BACKGROUND
Interleukin-1 receptor antagonist (IL-1Ra) levels are elevated early in patients with acute myocardial infarction (MI) and often precede release of markers of necrosis; however, IL-1Ra levels did not correlate previously with infarct size and prognosis in such patients.


OBJECTIVE
The goal of our study was to evaluate prospectively the correlation between IL-1Ra levels upon emergency department (ED) presentation and the extent of myocardial necrosis and prognosis in patients with ST-segment elevation MI.


METHODS
Levels of IL-1Ra were measured upon ED presentation in 44 consecutive patients (40 men, aged 55 +/- 10 years). Peak values of creatine kinase (CK) and CK-MB were determined during hospitalization, and left ventricular ejection fraction (LVEF) was evaluated by echocardiography before discharge. All patients were followed prospectively and underwent clinical and echocardiographic assessment at 42 +/- 3 months after the infarction.


RESULTS
Levels of IL-1Ra upon ED presentation correlated directly with CK (p = 0.002) and CK-MB (p = 0.01) peak levels and correlated inversely with LVEF before discharge (p = 0.009). Patients with in-hospital adverse events had significantly higher IL-1Ra levels upon ED admission (n = 10,2620 +/- 4706 pg/ml) than those without events (n = 34,598 +/- 457 pg/ml) (p = 0.015).


CONCLUSIONS
In patients with MI, levels of IL-1Ra upon ED presentation correlated significantly with the extent of myocardial necrosis, as measured by cardiac enzymes peak and reduction of LVEF, and are predictive of in-hospital events. Results of this study may influence early therapeutic approach in patients with acute MI.
Patti
Giuseppe
G
Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy.
Mega
Simona
S
Pasceri
Vincenzo
V
Nusca
Annunziata
A
Giorgi
Gabriele
G
Zardi
Enrico Maria
EM
D'Ambrosio
Andrea
A
Dobrina
Aldo
A
Di Sciascio
Germano
G
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007124:Immunoenzyme Techniques; D053590:Interleukin 1 Receptor Antagonist Protein; D007527:Isoenzymes / Q000097:blood; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012795:Sialoglycoproteins / Q000097:blood*; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D013997:Time Factors; D014463:Ultrasonography
D015415:Biomarkers; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D007527:Isoenzymes; D012795:Sialoglycoproteins; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form