IL-6, IL-1RA and Resistin as Predictors of Left Ventricular Remodelling and Major Adverse Cardiac Events in Patients with Acute ST Elevation Myocardial Infarction

Abstract

Despite continuous advances in diagnostic and therapeutic methods, acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. Considering the role of inflammation in AMI etiopathogenesis, we aimed to explore the role of a group of three inflammatory cytokines (IL-1RA, IL-6 and resistin) as an independent prognostic factor for LVR assessed by 3D echocardiography and MACE in patients with STEMI. We enrolled 41 patients with STEMI who underwent primary PCI. We assessed the occurrence of LVR (defined as an increase of over 20% in end-diastolic left ventricular volume at 6 months compared with baseline values) and MACE. Using the enzyme-linked immunosorbent assays (ELISA) method, we measured plasmatic levels of IL-6, IL-1RA and resistin (within 48 h after AMI and at 6 months). Out of 41 STEMI patients, 20.5% presented signs of LVR at follow up, and in 24.4%, MACE occurred. In univariate logistic regression analysis, baseline levels of IL-6 (OR = 1.042, p = 0.004), IL-1RA (OR = 1.004, p = 0.05) and resistin (OR = 1.7, p = 0.007) were all significantly associated with LVR. ROC analysis showed that the three cytokines as a group (AUC 0.946, p = 0.000) have a better predictive value for LVR than any individual cytokine. The group of cytokines also proved to have a better predictive value for MACE together than separately (AUC = 0.875, p = 0.000 for ROC regression model). IL-6, IL-1RA and resistin plasma levels at baseline have a good predictive value both as independent variables and also as a group for the development of adverse LVR and MACE at 6 months follow up after STEMI.

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.…”

“… 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. 23 Nevertheless, the prognostic value of inflammatory cytokines lacks comprehensive study at present.…”

“…Inflammation is non‐negligible in STEMI etiology, which is considered an essential process that participates in the initiation and progression of atherosclerotic plaque 9–11 . Consequently, some studies notice that the increased level of inflammatory cytokines possesses a certain value in predicting the MACE risk of STEMI patients, including interleukin (IL)‐1, IL‐6, IL‐17, IL‐37, etc 12–15 . For instance, one study suggests that the high level of IL‐6 is correlated with elevated MACE risk in STEMI patients who receive primary PCI treatment 13 .…”

“… 9 , 10 , 11 Consequently, some studies notice that the increased level of inflammatory cytokines possesses a certain value in predicting the MACE risk of STEMI patients, including interleukin (IL)‐1, IL‐6, IL‐17, IL‐37, etc. 12 , 13 , 14 , 15 For instance, one study suggests that the high level of IL‐6 is correlated with elevated MACE risk in STEMI patients who receive primary PCI treatment. 13 Another study shows that the high circulating IL‐37 level is a predictor of in‐hospital MACE rate in STEMI patients treated with PCI.…”

“… 12 , 13 , 14 , 15 For instance, one study suggests that the high level of IL‐6 is correlated with elevated MACE risk in STEMI patients who receive primary PCI treatment. 13 Another study shows that the high circulating IL‐37 level is a predictor of in‐hospital MACE rate in STEMI patients treated with PCI. 15 However, the previous studies only focus on a single or a few inflammatory cytokines (no more than three), and comprehensive studies focusing on the prognostic value of plentiful inflammatory cytokines in PCI‐treated STEMI patients remain rare.…”