title: Prognostic significance of interleukin-6 measurement in the diagnosis of acute myocardial infarction in emergency department.
abstract: BACKGROUND
  Markers of inflammation may predict both coronary artery disease (CAD) and adverse outcomes in patients with known CAD. Here, we investigated the role of interleukin-6 (IL-6) in the "triage" and risk assessment of patients admitted to emergency department (ED).
  
  
  METHODS
  Serum IL-6 and high sensitivity C-reactive protein (hs-CRP) levels were prospectively evaluated in 88 patients with a history of precordial chest pain or shortness of breath of recent onset (<6 h).
  
  
  RESULTS
  Of the 88 patients, 21% were discharged from the ED with diagnosis of non-ischemic chest pain (NICP), 39% had a final diagnosis of unstable angina (UA) and 40% experienced an acute myocardial infarction (AMI). Median IL-6 (p<0.001) and hs-CRP (p<0.01) levels on admission were significantly increased in patients with AMI compared with patients with NICP or UA. IL-6 levels correlated with hs-CRP (p<0.01). Multivariate analyses including known risk factors showed that elevated creatine kinase-MB (p<0.05) and IL-6 levels (p<0.01) were independently associated with a final diagnosis of AMI. Elevated IL-6 levels significantly predicted the risk of AMI (OR=2.47, p=0.006) in chest pain-enzyme negative patients.
  
  
  CONCLUSIONS
  IL-6 may behave as an adjunctive diagnostic tool to assist in the risk assessment of enzyme-negative patients with precordial chest pain of recent onset.
authors.affiliation: Department of Laboratory Medicine & Advanced Biotechnologies, IRCCS San Raffaele Pisana, Rome, Italy. patrizia.ferroni@sanraffaele.it
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ferroni
authors.forename: Antonello
authors.initials: A
authors.lastname: Rosa
authors.forename: Manuela
authors.initials: M
authors.lastname: Di Franco
authors.forename: Raffaele
authors.initials: R
authors.lastname: Palmirotta
authors.forename: Fiorella
authors.initials: F
authors.lastname: Guadagni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Davì
authors.forename: Giuliano
authors.initials: G
authors.lastname: Bertazzoni
authors.forename: Stefania
authors.initials: S
authors.lastname: Basili
mesh_terms: D000208:Acute Disease; D000210:Acute-Phase Reaction / Q000097:blood; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D052279:Creatine Kinase, MB Form / Q000032:analysis; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D009211:Myoglobin / Q000097:blood; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D009211:Myoglobin; D019210:Troponin I; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form