title: Clinical implications of elevated serum interleukin-6, soluble CD40 ligand, metalloproteinase-9, and tissue inhibitor of metalloproteinase-1 in patients with acute ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Atherosclerosis is widely accepted as a chronic inflammatory disease. Research paid much attention to sensitive specific serum biomarkers for vulnerable plaques. The markers not only serve as diagnostic tools for the identification of patients with acute coronary syndrome (ACS), but also help us to identify high-risk patients. However, the existing data are limited and have been conflicting.
  
  
  OBJECTIVE
  Circulating interleukin-6 (IL-6), soluble CD40 ligand (sCD40L), metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) might correlate with the onset and the cardiac mortality of patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  Serum levels of IL-6, sCD40L, MMP-9, and TIMP-1 were measured by sandwich enzyme-linked immunosorbent assay (ELISA) in 263 patients with STEMI and 262 age- and gender-matched control subjects without coronary artery disease (CAD). The patients with STEMI were then followed prospectively for 24 mo for the occurrence of cardiac mortality.
  
  
  RESULTS
  Compared with the control subjects, patients with STEMI exhibited higher levels of IL-6 (p<0.001), sCD40L (p<0.001), MMP-9 (p<0.001), TIMP-1 (p=0.045), and MMP-9/TIMP-1 ratio (p=0.007). Significant and positive correlations between MMP-9 and TIMP-1 (r=0.610, p<or=0.001]), IL-6 and creatine kinase (CK) (r=0.159, p=0.022), and IL-6 and Troponin-I (TnI) (r=0.141, p=0.042) were observed by Spearman's correlations analysis. Logistic regression analysis revealed that IL-6 significantly and independently correlated with the occurrence of STEMI, and IL-6 was an independent predictor for cardiac mortality during a 24-mo follow-up in patients with STEMI.
  
  
  CONCLUSIONS
  The present study indicates that elevated admission level of IL-6, but not of sCD40L, MMP-9, or TIMP-1, might indicate the onset of STEMI, and could provide prognostic value for future cardiac mortality within 2 y in patients with STEMI.
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Tan
authors.forename: Qi
authors.initials: Q
authors.lastname: Hua
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.forename: Zhen Xing
authors.initials: ZX
authors.lastname: Fan
mesh_terms: D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D016015:Logistic Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6; D019715:Tissue Inhibitor of Metalloproteinase-1; D023201:CD40 Ligand; D020780:Matrix Metalloproteinase 9
references.citation: Curr Opin Pharmacol. 2004 Apr;4(2):124-31
references.pmid: 15063355
references.citation: Clin Cardiol. 2005 Apr;28(4):182-6
references.pmid: 15869050
references.citation: Clin Cardiol. 2004 Jul;27(7):417-20
references.pmid: 15298045
references.citation: Circulation. 2000 Apr 18;101(15):1767-72
references.pmid: 10769275
references.citation: Ann Med. 2001 Feb;33(1):37-47
references.pmid: 11310937
references.citation: N Engl J Med. 1999 Jan 14;340(2):115-26
references.pmid: 9887164
references.citation: Proc Natl Acad Sci U S A. 2000 Jun 20;97(13):6930-2
references.pmid: 10860949
references.citation: Atherosclerosis. 2007 Oct;194(2):397-402
references.pmid: 16962598
references.citation: N Engl J Med. 2003 Mar 20;348(12):1104-11
references.pmid: 12646667
references.citation: Am Heart J. 2001 Feb;141(2):211-7
references.pmid: 11174334
references.citation: Nature. 2002 Dec 19-26;420(6917):868-74
references.pmid: 12490960
references.citation: Cardiol Clin. 1996 May;14(2):211-20
references.pmid: 8724553
references.citation: J Am Coll Cardiol. 2000 Sep;36(3):959-69
references.pmid: 10987628
references.citation: Circulation. 1995 Sep 15;92(6):1565-9
references.pmid: 7664441
references.citation: Circulation. 2003 Sep 2;108(9):1049-52
references.pmid: 12912804
references.citation: Circulation. 1997 Jul 15;96(2):396-9
references.pmid: 9244201