Association of interleukin-10 level with increased 30-day mortality in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention.
BACKGROUND
The prognostic value of interleukin (IL)-10 in patients with ST-segment elevation acute myocardial infarction (ST-se AMI) is currently unclear. The purpose of this study was to test whether the serum IL-10 level can predict 30-day mortality in patients with ST-se AMI undergoing primary percutaneous coronary intervention (PCI).


RESULTS
The study design was a prospective cohort study of 250 consecutive patients with ST-se AMI of onset <12 h who were undergoing primary PCI. Blood samples for serum IL-10 levels were collected in the catheterization laboratory following vascular puncture. The serum IL-10 level was also evaluated in 20 healthy and 30 at-risk control subjects. The mean serum level of IL-10 was significantly higher in the AMI patients than in either group of controls (all values of p<0.0001). Patients with a high serum IL-10 level (> or = 30 pg/ml) had a significantly lower left ventricular ejection fraction (LVEF) (defined as <50%), significantly higher incidence of cardiogenic shock, higher white blood cell (WBC) count, more advanced congestive heart failure (defined as New York Heart Association function classification of > or = 3), and increased 30-day mortality than those patients with a low serum IL-10 level (<30 pg/ml) (all values of p<0.0001). Multiple stepwise logistic regression analysis demonstrated that a high serum IL-10 level, together with low LVEF, high WBC count and unsuccessful reperfusion, was independently predictive of increased 30-day mortality (all values of p<0.005).


CONCLUSIONS
In patients with ST-se AMI, the serum IL-10 level is a major independent predictor of 30-day mortality and should be used for early risk stratification following acute myocardial infarction.
Yip
Hon-Kan
HK
Division of Cardiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University Collage of Medicine, Kaohsiung, Taiwan.
Youssef
Ali A
AA
Chang
Li-Teh
LT
Yang
Cheng-Hsu
CH
Sheu
Jiunn-Jye
JJ
Chua
Sarah
S
Yeh
Kuo-Ho
KH
Lee
Fan-Yen
FY
Wu
Chiung-Jen
CJ
Hang
Chi-Ling
CL
D000368:Aged; D000800:Angioplasty, Balloon; D000077144:Clopidogrel; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000031:analogs & derivatives / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D016753:Interleukin-10; D014443:Tyrosine; D000077144:Clopidogrel; D000077466:Tirofiban; D013988:Ticlopidine