Toll-Like Receptors/TNF-α Pathway Crosstalk and Impact on Different Sites of Recurrent Myocardial Infarction in Elderly Patients

Abstract

Background. Recurrent myocardial infarction is associated with increased mortality. Risk and predictive factors of recurrent myocardial infarction in elderly patients after coronary stenting are not well known. This research sought to investigate the effects of proinflammatory cytokines and toll-like receptor on recurrent myocardial infarction after coronary stenting in elderly patients. Methods. We measured the levels of toll-like receptor 2 (TLR2), toll-like receptor 3 (TLR3), toll-like receptor 4 (TLR4), tumor necrosis factor-α (TNF-α), soluble tumor necrosis factor-α receptor-1 (sTNFR-1), soluble tumor necrosis factor-α receptor-2 (sTNFR-2), endothelial progenitor cells (EPCs), and vascular endothelial growth factor (VEGF) in elderly patients with recurrent myocardial infarction and assessed the changes of proinflammatory cytokines and toll-like receptors in elderly patients with recurrent myocardial infarction after coronary stenting. Results. Levels of TLR2, TLR3, TLR4, TNF-α, sTNFR-1, and sTNFR-2 were remarkably increased ( P < 0.001 ), and EPCs and VEGF were remarkably lowered ( P < 0.001 ) in the elderly patients with recurrent myocardial infarction after coronary stent implantation. Increased expressions of proinflammatory cytokines and toll-like receptors induced recurrent myocardial infarction after coronary stenting. Elevated expressions of proinflammatory cytokines and toll-like receptors may be used to identify elderly patients who have an increased risk of developing recurrent myocardial infarction after coronary stenting. Conclusion. The increase levels of proinflammatory cytokines and toll-like receptors were associated with recurrent myocardial infarction after coronary stenting. Increased expressions of proinflammatory cytokines and toll-like receptors may be clinically useful biomarkers for predicting recurrent myocardial infarction in the elderly patients after coronary stent implantation.

Levels of soluble tumor necrosis factor receptor 1 and 2 are associated with survival after ST segment elevation myocardial infarction

“…As TNF-α is released upon plaque rupture 21 , measurements of TNF-α could be assumed to be a more accurate way of studying the physiological processes, but this was not seen as a good alternative, as TNF-α has been reported to have a short half-life in stored samples 16 . However, studies measuring both TNF-α and sTNFRs show similar trends for these markers 14 , 15 , 20 , which makes it likely that we would have seen the same results also with TNF-α in our patients.…”

“…It has also been associated with increased risk for heart failure 11 , incident myocardial infarction 12 and cardiovascular death 13 in population-based studies. Increased levels have also been found in patients with recurrent ventricular arrhythmia 14 or recurrent myocardial infarction 15 after coronary stenting. However, only a few studies so far have measured sTNFRs in patients with acute ST-segment elevation myocardial infarction (STEMI) 16 – 18 .…”

Identification of hub biomarkers of myocardial infarction by single-cell sequencing, bioinformatics, and machine learning

“…Li et al found that the increased expression of TLR2 supported the point that proinflammatory TLR was involved in the pathogenesis of MI. TLR2 was a predictive biomarker in elderly patients with MI ( 38 ). Consequently, IL1B and TLR2 were important biomarkers of MI.…”