Proinflammatory cytokines changes in clinical course of acute myocardial infarction

Abstract

Purpose: to evaluate the interrelationships of proinflammatory cytokines serum levels with the development of acute myocardial infarction (MI) complications. Materials and methods. Eighty two patients with AMI were studied. Prospective short-term study included, patients with uncomplicated non-Q wave MI (n = 27), patients with Q-wave MI complicated by acute left ventricular insufficiency Killip class I–II (n = 30), patients with Q-wave MI complicated by acute left ventricular insufficiency Killip class III–IV (n = 17), non-survivors due to development of cardiogenic shock (n = 8) and age and gender matched healthy controls (n = 12). Serum levels of IL-1β, IL-6 and TNF-α had been evaluated by means of ELISA method. Blood samples had been drawn on admission to the hospital within 18–28 hours from the onset of symptoms, at 3d and 14th days of MI. Risk stratification was assessed on admission according to the GUSTO Score. Results. All cytokines levels were significantly elevated in MI patients in comparison to controls. Mean concentrations of IL-6 at baseline were higher among patients with MI complicated by cardiogenic shock than in group with uncomplicated MI (27,45 vs 16,04 pg/mL; р < 0,001). The same was revealed in concentration of TNF-α (24,74 vs 19,58 pg/mL; р < 0,01), while mean concentration of IL-1β did not differ significantly between these two groups. Non-survivors also showed significantly higher levels of IL-6, TNF-α than all groups of survived patients. Conclusions. Increased levels of IL-6 and TNF-α at 1-st day of MI are associated with the development of acute left ventricular insufficiency and unfavorable prognosis.