Association of inflammatory markers and poor outcome in diabetic patients presenting with ST segment elevation myocardial infarction

Abstract

ObjectiveCarbohydrate metabolism disorders (CMD) significantly impact the development and progression of all forms of ischemic heart disease, and inflammation is regarded as a general pathogenetic link between CMD and ischemic heart disease.MethodsA total of 601 patients with ST segment elevation myocardial infarction (MI) (STEMI), admitted within 24 hours from the onset of symptoms during 1 year, were included in this registry study. The blood levels of inflammation markers were measured at days 10–14 with further follow up at 1 year.ResultsThe analysis of acute-phase percutaneous coronary intervention impact on the 1-year outcomes showed that endovascular revascularization significantly improved the 1-year prognosis of STEMI patients both with and without CMD. The analysis of inflammation markers showed significantly higher levels of interleukin (IL)-6 and sCD40L in MI patients with diabetes mellitus, and impaired glucose tolerance. Additionally, the patients with impaired glucose tolerance had significantly higher IL-12 levels. In the diabetic MI patients, the odds ratio of a poor 1-year outcome was high for patients with a high Killip classification of acute heart failure upon admission.ConclusionPersistent inflammation in STEMI patients with CMD undergoing percutaneous coronary intervention might be responsible for vascular complications within 1 year after MI. Comorbid diabetes mellitus or impaired glucose tolerance can amplify the significance of the inflammatory response for the development of adverse 1-year outcomes.

Association between interleukin-6/6R gene polymorphisms and coronary artery disease in Russian population: influence of interleukin-6/6R gene polymorphisms on inflammatory markers

“…These findings may suggest that different settings may be regulated by different cytokine production pathways and that IL-6 together with IL-6R has a biological role in susceptibility to CAD. It is also known that the balance between pro-inflammatory and anti-inflammatory markers has a critical role in the development of CAD 19–21. In this direction, different sets of epidemiological studies have revealed that specific SNPs in different genes, such as IL-6, IL-16, IL-17, IL-18, and IL-23, are associated with the development of CAD 22–28.…”

“…It is also known that the balance between pro-inflammatory and anti-inflammatory markers has a critical role in the development of CAD. 19 – 21 In this direction, different sets of epidemiological studies have revealed that specific SNPs in different genes, such as IL-6, IL-16, IL-17, IL-18, and IL-23, are associated with the development of CAD. 22 – 28 The results from this research, regarding T allele from rs2069860, associated with the patients without CAD, suggest that rs2069860 is typical for the development of hypertension or diabetes mellitus type II but not for CAD.…”