Subacute Inflammatory Activation in Subjects with Acute Coronary Syndrome and Left Ventricular Dysfunction

Abstract

Several lines of evidence indicate that increased inflammatory cytokine levels can be used for risk prediction in patients with acute coronary syndrome (ACS). This study therefore aimed to evaluate correlations between levels of soluble interleukin (IL)-2 receptor (sIL-2r), IL-6, and IL-8 and in-hospital incidence of acute heart failure (AHF) and left ventricular (LV) systolic dysfunction in the subacute phase of ACS. In 48 consecutive patients with ACS, circulating levels of sIL-2r, IL-6, and IL-8 were ascertained 72-96 h after onset of symptoms. Clinical data, LV function, and in-hospital incidence of AHF were also evaluated. IL-8 levels were significantly higher in patients with pulmonary edema (1,829 ± 2,496 vs 456 ± 624 pg/ml, p < 0.05); sIL-2r, IL-6, and IL-8 levels were increased proportionally to Killip class (r = 0.35, p < 0.05; r = 0.48, r = 0.47, p < 0.01) and in patients with LV ejection fraction (LVEF) < 30%. Levels of sIL-2r were inversely related to LVEF in subjects with acute myocardial infarction (r = -0.51, p < 0.05). Soluble IL-2r and IL-8 levels were related to mitral regurgitation severity (r = 0.34, p < 0.05; r = 0.37, p < 0.05). Levels of sIL-2 were proportional to LV end-diastolic diameter (r = 0.49, p < 0.001) and LV end-systolic diameter (r = 0.58, p < 0.001). Number of cytokines with circulating values above upper level of normal was significantly correlated with Killip class and LVEF (r = 0.40, r = -0.38, p < 0.05). sIL-2r, IL-6, and IL-8 are increased in patients with ACS and systolic dysfunction or AHF. These data suggest that inflammatory cytokine activity detectable in peripheral blood may be useful in identifying subjects with a worse clinical course.

The Link Between Cardio-Metabolic Risk Factors, Serum sIL-2R and Echocardiography Data in Type 2 Diabetes

“…On the other hand, one meta analysis study reviewed twelve studies and the authors concluded that sIL-2R is not a useful inflammatory marker of coronary artery calcification (13). In (14). This study demonstrates such findings but in asymptomatic patients and in absence of acute myocardial infarction.…”

“…In heart failure of whatever cause, serum sIL-2R level is high before treatment, and then reduced after using therapeutic agents with pleiotropic effects like statins (7). Recent study shows that sIL-2R level is high in patients with acute coronary syndrome in presence of systolic dysfunction or acute heart failure, and the levels of sIL-2R were proportional to left ventricle end-diastolic diameter and endsystolic diameter (8). Cardiometabolic risk factors as well as abnormal ventricular function often exited in diabetic patients.…”

Correlation between Inflammatory Markers and Lipid Parameters in a Tunisian Coronary Artery Disease Group

“…Several studies [5]- [7] have shown that IL6 and other pro-inflammatory cytokines were significantly increased in patients with acute coronary syndrome.…”

Correlation of serum high-sensitivity C-reactive protein and interleukin-6 in patients with acute coronary syndrome

“…When plaque has inflammation or rupturing, the blood concentrations of IL-6 tend to increase. IL-6 and other cytokines were significantly increased in ACS patients (De Gennaro et al, 2012). Lai et al (2011) also found that serum IL-6 levels of plaque in ACS patients were significantly higher than those of the control group, while IL-6 levels of the unstable and mixed plaque group were also significantly higher than the control group.…”