Open AccessInterleukin‐1 receptor antagonist levels correlate with extent of myocardial loss in patients with acute myocardial infarction
Author(s) -
Patti Giuseppe,
Mega Simona,
Pasceri Vincenzo,
Nusca Annunziata,
Giorgi Gabriele,
Zardi Enrico Maria,
D'Ambrosio Andrea,
Dobrina Aldo,
Di Sciascio Germano
Publication year - 2005
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960280409
Subject(s) - medicine , ejection fraction , myocardial infarction , cardiology , creatine kinase , interleukin 1 receptor antagonist , emergency department , receptor antagonist , necrosis , prospective cohort study , infarction , antagonist , heart failure , receptor , psychiatry
Background : Interleukin‐1 receptor antagonist (IL‐1 Ra) levels are elevated early in patients with acute myocardial infarction (MI) and often precede release of markers of necrosis; however, IL‐1Ra levels did not correlate previously with infarct size and prognosis in such patients. Hypothesis : The goal of our study was to evaluate prospectively the correlation between IL‐1Ra levels upon emergency department (ED) presentation and the extent of myocardial necrosis and prognosis in patients with ST‐segment elevation MI. Methods : Levels of IL‐1Ra were measured upon ED presentation in 44 consecutive patients (40 men, aged 55 ± 10 years). Peak values of creatine kinase (CK) and CK‐MB were determined during hospitalization, and left ventricular ejection fraction (LVEF) was evaluated by echocardiography before discharge. All patients were followed prospectively and underwent clinical and echocardiographic assessment at 42 ± 3 months after the infarction. Results : Levels of IL‐1Ra upon ED presentation correlated directly with CK (p = 0.002) and CK‐MB (p = 0.01) peak levels and correlated inversely with LVEF before discharge (p = 0.009). Patients with in‐hospital adverse events had significantly higher IL‐1Ra levels upon ED admission (n = 10,2620 ± 4706 pg/ml) than those without events (n = 34, 598 ± 457 pg/ml)(p = 0.015). Conclusions : In patients with MI, levels of IL‐1Ra upon ED presentation correlated significantly with the extent of myocardial necrosis, as measured by cardiac enzymes peak and reduction of LVEF, and are predictive of in‐hospital events. Results of this study may influence early therapeutic approach in patients with acute MI.