Aging adversely affects postinfarction inflammatory response and early left ventricular remodeling after reperfused acute anterior myocardial infarction.
OBJECTIVE
We have demonstrated that an increased peak serum C-reactive protein (CRP) level after acute myocardial infarction (AMI) was a major predictor of left ventricular (LV) remodeling. We sought to clarify the effect of aging on the postinfarction inflammatory response and LV remodeling.


METHODS
We studied 102 patients who underwent primary angioplasty for a first anterior Q-wave AMI. Serum CRP levels, plasma neurohormones and interleukin-6 (IL-6) levels, and LV volume by left ventriculography were serially measured. Patients were divided into two groups according to their age (>or=70 years, n=33; <70 years, n=69).


RESULTS
There was no difference in use of cardiovascular drugs and coronary angiographic findings. Older patients had a greater increase in LV end-diastolic volume during 2 weeks after AMI (p=0.0007) and a higher peak CRP level (12.4+/-7.3 vs. 5.5+/-4.2 mg/dl, p<0.0001), although peak CK level was comparable between the two groups. Plasma atrial natriuretic peptide, brain natriuretic peptide and IL-6 levels were higher in older patients at 2 weeks and 6 months after AMI.


CONCLUSIONS
Augmented and prolonged activation of the inflammatory system after AMI was observed in older patients, in association with exaggerated LV remodeling. Aging may adversely affect LV remodeling through modification of the inflammatory response after AMI.
Mahara
Keitaro
K
Department of Medicine, Division of Cardiology, Keio University School of Medicine, Tokyo, and National Hospital Organization, Saitama National Hospital, Japan.
Anzai
Toshihisa
T
Yoshikawa
Tsutomu
T
Maekawa
Yuichiro
Y
Okabe
Teruo
T
Asakura
Yasushi
Y
Satoh
Toru
T
Mitamura
Hideo
H
Suzuki
Masahiro
M
Murayama
Akira
A
Ogawa
Satoshi
S
D000368:Aged; D000375:Aging / Q000502:physiology*; D009320:Atrial Natriuretic Factor / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D015425:Myocardial Reperfusion; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D012044:Regression Analysis; D016276:Ventricular Function; D020257:Ventricular Remodeling / Q000502:physiology*
D015850:Interleukin-6; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D002097:C-Reactive Protein; D003402:Creatine Kinase