Serum interleukin 6 and 10 levels in Takotsubo cardiomyopathy: Increased admission levels may predict adverse events at follow-up.
Systemic inflammation has been hypothesized as a possible mechanism of Takotsubo cardiomyopathy (TTC). Aim of the study was to assess the role of interleukin (IL)-6 and IL-10 in subjects with an episode of TTC.



Fifty-six consecutive subjects with TTC were prospectively enrolled in the study and followed for a mean of 178 days. Circulating levels of IL-6, IL-10, clinical condition and left ventricular ejection fraction were evaluated at admission. Incidence of death, re-hospitalization and recurrence of TTC during follow-up was also recorded.



23% of patients experienced in-hospital complications while 20% of patients had adverse events at follow-up. IL-6 and IL-10 serum levels at admission were higher in subjects with adverse events at follow-up (120 ± 294 vs. 22 ± 40 pg/ml, p<0.05; 13 ± 35 vs. 2 ± 3 pg/ml, p=0.05, respectively). Increased serum levels of IL-6 and IL-10 were associated with higher adverse events rates at follow-up (Log-Rank p<0.001, <0.05, hazard ratio 8.6, 5.1, respectively) and mortality rates (Log-Rank p<0.001, p<0.05, hazard ratio 20.8, 7.1, respectively). Subjects with both increased IL-6 and IL-10 levels were characterized by an increased risk of adverse events when compared to subjects with only IL-6 or IL-10 increased levels or with values below cutoff values (Log-Rank p<0.01 for any event, <0.001 for death; hazard ratio 1.20 for any event, 1.31 for death), even after correction for age, LVEF and NTproBNP levels in multivariable Cox analysis.



Serum IL-6 and IL-10 admission levels are associated with higher risk of adverse events during follow-up.
University of Foggia, Foggia, Italy; Asklepios Sankt Georg Klinik, Hamburg, Germany.
Francesco
F
Santoro
University of Foggia, Foggia, Italy.
Nicola
N
Tarantino
University of Foggia, Foggia, Italy.
Armando
A
Ferraretti
Ospedali Riuniti University Hospital, Foggia, Italy.
Riccardo
R
Ieva
University of Foggia, Foggia, Italy.
Francesco
F
Musaico
University of Foggia, Foggia, Italy.
Francesca
F
Guastafierro
University of Foggia, Foggia, Italy.
Luigi
L
Di Martino
University of Foggia, Foggia, Italy.
Matteo
M
Di Biase
University of Foggia, Foggia, Italy. Electronic address: natale.brunetti@unifg.it.
Natale Daniele
ND
Brunetti
D000208:Acute Disease; D000368:Aged; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D010343:Patient Admission; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D054549:Takotsubo Cardiomyopathy / Q000097:blood* / Q000628:therapy; D016277:Ventricular Function, Left
C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016753:Interleukin-10
Interleukin-10; Interleukin-6; Prognosis; Takotsubo cardiomyopathy