High levels of interleukin-6 are associated with final infarct size and adverse clinical events in patients with STEMI

Abstract

ObjectiveInflammation has emerged as a new treatment target in patients with coronary artery disease and inflammation seems to play an important role in ischaemia/reperfusion injury that follows ST-elevation myocardial infarction (STEMI). We aimed to explore the role of acute and sustained interleukin 6 (IL-6) signalling, including soluble IL-6 receptor (IL-6R), with regard to infarct size, adverse remodelling and future cardiovascular events in patients with STEMI.MethodsWe included 269 patients with first-time STEMI, symptom duration <6 hours and treated with percutaneous coronary intervention. Blood sampling and cardiac MRI were performed in the acute phase and after 4 months. Clinical events and all-cause mortality were registered during 12-month and 70-month follow-up, respectively.ResultsIL-6 levels above median at all sampling points were significantly associated with increased infarct size and reduced left ventricular ejection fraction (LVEF). IL-6 levels in the highest quartile were at all sampling points associated with an increased risk of having an adverse clinical event during the first 12 months and with long-term all-cause mortality. IL-6R was not associated with infarct size, LVEF, myocardial salvage or long-term all-cause mortality.ConclusionAcute and sustained elevation of IL-6 measured 4 months after STEMI were associated with larger infarct size, reduced LVEF and adverse clinical events including all-cause mortality. The results add important information to the sustained role of inflammation in patients with STEMI and IL-6 as a potential target for long-term intervention.Trial registration numberNCT00922675.

The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

“…A few studies have been carried out to explore the correlation of some specific inflammatory cytokines with MACE risk in STEMI patients. 13 , 15 , 23 , 24 , 25 For example, one previous study indicates that the elevation of IL‐6 is correlated with high MACE risk in STEMI patients who undergo PCI therapy. 13 Another study finds the important role of VCAM‐1 in the occurrence of post‐PCI restenosis.…”

Infarct size, inflammatory burden, and admission hyperglycemia in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: a multicenter international registry

“…Mounting evidence suggests that neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-platelet ratio (NPR) might be considered as biomarkers of systemic inflammation and associated with poor clinical outcomes in various cardiovascular diseases, including acute coronary syndromes (ACS) [ 1 , 6 – 8 ]. Moreover, recent investigations have shown that the inflammatory status correlates with infarct size and adverse clinical outcome in ACS patients [ 9 , 10 ].…”

Clinical usefulness of cytokines as diagnostic and follow up markers in patients with stable angina pectoris

“…Our results were also in agreement with the results of Groot et al (2019) who show that the median baseline IL-6 level was (3.7 pg/ml) and it was increased a threefold to (10.3 pg/ml) (p<0.001) after 24 h and subsequently decreased to (1.8 pg/ml) )(p<0.001) at 2 weeks to remain stable. Furthermore, the study of Tøllefsen et al (2021) carried out on 269 individuals who had undergone STEMI revealed that circulating IL-6 levels rose from the day of admission to the first day after, and then dropped to levels lower than those at the time of admission at the 4month follow-up (p<0.001). Sun et al (2020) concluded that the pre-operative expression of IL-6 (P<0.001) was increased in restenosis patients compared with non-restenosis patients.…”