title: Release kinetics of inflammatory biomarkers in a clinical model of acute myocardial infarction.
abstract: BACKGROUND
  Inflammation in the setting of acute myocardial infarction (MI) has been linked to risk stratification; however, the release kinetics of inflammatory biomarkers in patients with acute MI has been difficult to establish.
  
  
  OBJECTIVE
  The aim of this study was to determine the kinetics of changes in the levels of several biomarkers specifically linked to inflammation after transcoronary ablation of septal hypertrophy, a procedure that mimics acute MI.
  
  
  RESULTS
  We analyzed release kinetics of C-reactive protein, high-sensitivity C-reactive protein, interleukin-6, soluble CD40 ligand, and peripheral blood leukocyte subsets in patients (n=21) undergoing transcoronary ablation of septal hypertrophy. Blood samples were collected before transcoronary ablation of septal hypertrophy and at various times after transcoronary ablation of septal hypertrophy. Serum levels of C-reactive protein were increased at 24 hours (1.0 mg/dL [interquartile range [IQR], 0.7-1.75] versus 0.2 mg/dL [IQR, 0.1-1.05] at baseline [BL]; P<0.001), whereas high-sensitivity C-reactive protein increased as early as 8 hours (2.68 mg/L [IQR, 1.23-11.80] versus 2.17 mg/L [IQR, 1.15-5.06] at BL; P=0.002). Interleukin-6 was significantly increased at 45 minutes (2.59 pg/mL [IQR, 1.69-5.0] versus 1.5 pg/mL [IQR, 1.5-2.21] at BL; P=0.002), and soluble CD40 ligand was significantly decreased at 60 minutes (801.6 pg/mL [IQR, 675.0-1653.5] versus 1750.0 pg/mL [IQR, 1151.0-2783.0] at BL; P=0.016). Elevated counts of polymorphonuclear neutrophils were detectable at 15 minutes, with a significant increase at 2 hours (6415 cells/μL [IQR, 5288-7827] versus 4697 cells/μL [IQR, 2892-5620] at BL; P=0.004). Significant monocytosis was observed at 24 hours (729 cells/μL [IQR, 584-1344] versus 523 cells/μL [IQR, 369-701] at BL; P=0.015).
  
  
  CONCLUSIONS
  Interleukin-6 and neutrophil granulocytes showed a continuous rise at all prespecified time points after induction of MI. Our results provide valuable additional evidence of the diagnostic value of inflammatory biomarkers in the setting of early acute MI.
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.). c.liebetrau@kerckhoff-klinik.de j.hoffmann@kerckhoff-fgi.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Liebetrau
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.). c.liebetrau@kerckhoff-klinik.de j.hoffmann@kerckhoff-fgi.de.
authors.forename: Jedrzej
authors.initials: J
authors.lastname: Hoffmann
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Luise
authors.initials: L
authors.lastname: Gaede
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Johannes
authors.initials: J
authors.lastname: Blumenstein
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Hannes
authors.initials: H
authors.lastname: Biermann
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Lukas
authors.initials: L
authors.lastname: Pyttel
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Peter
authors.initials: P
authors.lastname: Thiele
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Christian
authors.initials: C
authors.lastname: Troidl
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Alexander
authors.initials: A
authors.lastname: Berkowitsch
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Andreas
authors.initials: A
authors.lastname: Rolf
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Sandra
authors.initials: S
authors.lastname: Voss
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.affiliation: From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.).
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
mesh_terms: D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D023201:CD40 Ligand / Q000097:blood / Q000378:metabolism*; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006346:Heart Septum / Q000473:pathology / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism*; D007700:Kinetics; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology; D009203:Myocardial Infarction; D009504:Neutrophils / Q000473:pathology; D012636:Secretory Rate; D020107:Troponin T / Q000097:blood / Q000378:metabolism*
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D020107:Troponin T; D023201:CD40 Ligand; D002097:C-Reactive Protein
keywords: acute myocardial infarction; inflammation; leukocytes