Interleukin-6 but not soluble adhesion molecules has short-term prognostic value on mortality in patients with acute ST-segment elevation myocardial infarction
Inflammatory responses represent an important element in all phases of the atherosclerotic process. This recognition has stimulated the evaluation of different inflammatory markers as potential predictors of cardiovascular risk. This study was designed to simultaneously measure serum levels of interleukin- 6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble P-selectin (sP-selectin) in patients with acute ST-segment elevation myocardial infarction (STEMI) and to evaluate their ability to predict short-term prognosis. We recruited 263 consecutive patients admitted to our institute within 6 h of symptoms onset with the diagnosis of first STEMI. Clinical data were recorded and serum admission levels of IL-6, sICAM-1, sVCAM-1 and sPselectin were measured. The patients were then followed prospectively for the occurrence of cardiovascular mortality for 4 weeks. Nineteen (7.2%) patients died during the 4 weeks. The admission levels of IL-6 were significantly higher in patients who died from cardiovascular causes, whereas sICAM-1, sVCAM-1, and sP-selectin were not. Kaplan–Meier plots demonstrated a significant increase in cardiovascular mortality with increasing IL-6 levels (P = 0.0060). Logistic regression analysis revealed that IL-6 was an independent predictor for cardiovascular mortality. The present study indicates that elevated admission level of IL-6 but not soluble adhesion molecules could provide valuable information for short-term risk stratification in patients with STEMI.
Key words: Acute ST-segment elevation myocardial infarction, interleukin-6, soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, soluble P-selectin, cardiovascular mortality.