title: Aging adversely affects postinfarction inflammatory response and early left ventricular remodeling after reperfused acute anterior myocardial infarction.
abstract: 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.
authors.affiliation: Department of Medicine, Division of Cardiology, Keio University School of Medicine, Tokyo, and National Hospital Organization, Saitama National Hospital, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Mahara
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Teruo
authors.initials: T
authors.lastname: Okabe
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Asakura
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
authors.forename: Hideo
authors.initials: H
authors.lastname: Mitamura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Suzuki
authors.forename: Akira
authors.initials: A
authors.lastname: Murayama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogawa
mesh_terms: 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*
chemical_list: D015850:Interleukin-6; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D002097:C-Reactive Protein; D003402:Creatine Kinase