Interleukin-1 receptor antagonist levels correlate with extent of myocardial loss in patients with acute myocardial infarction

Giuseppe Patti, Simona Mega, Vincenzo Pasceri, Annunziata Nusca, Gabriele Giorgi, Enrico Maria Zardi, Andrea D'Ambrosio, Aldo Dobrina, Germano Di Sciascio
2005 Clinical Cardiology  
Interleukin-1 receptor antagonist (IL-1Ra) 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
more » ... 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.
doi:10.1002/clc.4960280409 pmid:15869054 fatcat:auggkwad2vcxflyl76nlowbiei