Levels of T-lymphocyte subpopulations, interleukin-1β, and soluble interleukin-2 receptor in acute myocardial infarction

Abstract

T-lymphocyte levels may adversely affect the clinical course and outcome of patients with acute myocardial infarction (AMI). To characterize the T-lymphocyte profile during AMI and to explore whether these cells play a detrimental role in the extent of myocardial insult, levels of T-lymphocyte subpopulations, free soluble interleukin-2 receptor (sIL-2R), and interleukin-1β (IL-1β), were measured during the first week of AMI. Results were correlated with left ventricular ejection fraction (LVEF), age, sex, survival rate, thrombolytic therapy, and the occurrence of reinfarction. Thirty-nine patients, 20 men and 19 women aged 30 to 80 years, with first AMI were included. Patients were divided into two groups. Group A (13 patients) experienced reinfarction; group B (26 patients) did not. T-helper and-suppressor cells were measured by the indirect immunofluorescence method and sIL-2R and IL-1 serum levels by enzyme-linked immunosorbent assay (ELISA) methods on days 1, 4, and 7 after AMI. A low count of T-helper cells (CD 4) was found on the first day after AMI in both AMI groups; however, the count returned to normal in group B but not in group A. A significant correlation ( r = 0.63) was found between T-helper cell count on day 4 of AMI and LVEF assessed by radionuclide ventriculography, and between the CD 4 CD 8 ratio on day 1 and the creatine phosphokinase level ( r = −0.6950). High sIL-2R levels were found in groups A and B of the AMI patients as compared with the control group ( p ≤ 0.05). Significantly higher levels of sIL-2R were found in group A, showing a steady increase from day 1 to day 7 ( p = 0.026). The same was true for the IL-1β levels in group A. In group B the IL-1β level was high on the first day and returned to normal on the seventh day. Furthermore, we found that the higher the sIL-2R level, the lower the EF and the higher the probability of death ( r = −0.74 for EF; p = 0.005 for death on day 7). We conclude that T-lymphocytes, IL-1β, and sIL-2R levels potentially influence ultimate infarct size, myocardial damage, and outcome in patients with AMI.