Prognostic value of serum levels of interleukin-6 in patients with ST-segment elevation acute myocardial infarction.
BACKGROUND
Interleukin-6 (IL6) plays a role in atherogenesis as well as in most atherothrombotic phenomenon such as ST-segment elevation acute myocardial infarction (STEAMI). Our objective was to evaluate serum levels of IL6 as prognostic value for major clinical in-hospital events in patients with STEAMI.


METHODS
We studied consecutive patients with diagnosis of STEAMI according to ACC/AHA/ESC criteria. Twenty four hours after the acute event, IL6 was determined by chemiluminescence method. The major cardiovascular end points were arrhythmias, angina, heart failure, reinfarction and death.


RESULTS
Included were 97 patients. The level of IL6 to identify high-risk patients was 20 pg/ml. Forty six patients had <20 pg/ml (group I), and 51 patients had >20 pg/ml (group II). Mean value of IL6 was 11.52 +/- 4.83 pg/ml vs. 63.19 +/- 44.4 pg/ml (p <0.0001). Death was more frequent (2.2 vs. 15.7%, p = 0.023, RR 1.16 95% CI 1.02-1.31) and the end point combined during hospitalization in group II was 21.7 vs. 51% (p = 0.003 RR 1.59 95% CI 1.16-2.19). Multivariate logistic regression analysis identified Killip class > or = 2 and IL6 levels > or = 20 pg/ml as predictors for in-hospital end point.


CONCLUSIONS
Serum levels of IL6 >20 pg/ml in the first 24 h after STEAMI were significantly associated with higher frequency of in-hospital outcomes such as arrhythmias and death.
Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), México, D.F., Mexico. gborrayos@yahoo.com.mx
Gabriela
G
Borrayo-Sánchez
Alex
A
Pacheco-Bouthillier
Lorena
L
Mendoza-Valdez
Irma
I
Isordia-Salas
Rubén
R
Argüero-Sánchez
Guillermo
G
Careaga Reyna
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000453:epidemiology / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D050197:Atherosclerosis / Q000097:blood / Q000150:complications; D015415:Biomarkers; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012306:Risk; D012680:Sensitivity and Specificity; D019851:Thrombophilia / Q000097:blood / Q000209:etiology
D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6