Plasma interleukin 6 levels are associated with cardiac function after ST-elevation myocardial infarction

Abstract

Background and aims Myocardial infarction triggers an inflammatory response involved in cardiac repair. We studied the association of the interleukin 6 (IL-6) cascade with infarct size and cardiac function after ST-elevation myocardial infarction (STEMI). Methods In 369 STEMI patients IL-6, soluble IL-6 receptor (sIL-6R), and soluble glycoprotein (sgp) 130 were measured at baseline (hospital admission), 24 h, 2 weeks, 7 weeks, 4 months, and 1 year post-PCI and sIL-6R/IL-6 ratio was calculated. At 4 months, infarct size and left ventricular ejection fraction (LVEF) were assessed by magnetic resonance imaging. Diastolic function ( E / e ′) was determined by echocardiography. Results Hospital admission levels for IL-6, sIL-6R, sgp 130 were 3.7 pg/ml (IQR 2.1–6.7 pg/ml), 51.6 ng/ml (IQR 37.3–69.0 ng/ml), and 332 ng/ml (IQR 280–399 ng/ml), respectively. 24 h after admission, IL-6 had increased threefold compared to baseline ( p < 0.001) and returned below baseline ( p < 0.001) 2 weeks after STEMI. sIL-6R and sgp130 levels at 24 h remained similar to baseline but were increased at 2 weeks ( p < 0.001; p < 0.001, respectively). IL-6 and sIL-6R/IL-6 ratio at 24 h were independently associated with infarct size [ β 5.4 (95% CI 3.3–7.5); p < 0.001, β − 4.0 (95% CI − 6.1 to − 1.9); p < 0.001, respectively]. Higher levels of IL-6 at 24 h were associated with lower LVEF [ β − 4.2 (95% CI -6.7 to − 1.8); p = 0.001]. Conclusions Higher IL-6 and lower sIL-6R/IL-6 ratio early after presentation with STEMI are indicative for larger infarct size and decreased cardiac function at 4 months. Electronic supplementary material The online version of this article (10.1007/s00392-018-1387-z) contains supplementary material, which is available to authorized users.

Associations between IL-6 and Echo-Parameters in Patients with Early Onset Coronary Artery Disease

“…IL-6 level in patients with significant angiographically lesions was significantly higher than in patients with non-significant lesions or the control group (45.5 pg/mL vs. 9.22 pg/mL vs. 3.83 pg/mL, respectively; p < 0.001) [9]. Several studies indicate that the highest IL-6 levels are reached on the first day after MI (as a result of myocardial necrosis), and thereafter, a rapid decline occurs, obtaining a stable level after a few weeks (depending on the source from 2 weeks to 6 months) [24][25][26]. Furthermore, it does not change significantly over time [24,26,27].…”

“…Several studies indicate that the highest IL-6 levels are reached on the first day after MI (as a result of myocardial necrosis), and thereafter, a rapid decline occurs, obtaining a stable level after a few weeks (depending on the source from 2 weeks to 6 months) [24][25][26]. Furthermore, it does not change significantly over time [24,26,27]. Among survivors of MI, IL-6 levels are associated with traditional cardiovascular risk factors, such as age, pack-years of smoking, HDL cholesterol, or systolic blood pressure [27].…”

<p>The Role of Selected Pro-Inflammatory Cytokines in Pathogenesis of Ischemic Stroke</p>

“…The presence of the IL-6-174 GC genotype and a higher concentration of IL-6 receptors increase the likelihood of a stroke 12,56 as is the case in an acute myocardial infarction and other vascular diseases. [56][57][58] The relationship between the level of IL-6 in serum, the severity of neurological deficit as well as prognosis concerning patients with an acute ischemic stroke and the volume of an ischemic stroke is an object of interest of many researchers. Many authors indicate that the increase in the concentration of IL-6 in serum within the first 24 hrs following a stroke is associated with a deterioration of patients' functional state 43,55,59,60 and greater spectrum covered by the lesion volume 61,62 and they consider the level of IL-6 to be a reliable prognostic factor in the acute phase of ischemic stroke.…”

Pentraxin 3 might be better prognostic serum marker than IL-6, IL-10, and high-sensitivity C-reactive protein for major adverse cardiovascular events in patients with ST-elevation myocardial infarction after bare-metal stent implantation

“…11 Increased IL-6 plasma values and a lower sIL-6R/IL-6 ratio suggest decreased ejection fraction and larger size of infarct in a short period of time after myocardial infarction with ST-elevation. 12 In patients who received clopidogrel increased IL-6 plasma values are associated with either early or late stent thrombosis, indicating that cytokines are involved in the development of stent thrombosis. 13 Decreased plasma IL-10 levels in patients who developed in-stent restenosis suggest that it might play some important anti-inflammatory role in the development of in-stent restenosis.…”