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Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock

Debrunner, Marianne ; Schuiki, Ernst ; Minder, Elisabeth ; Straumann, Edwin ; Naegeli, Barbara ; Mury, Raymond ; Bertel, Osmund ; Frielingsdorf, Jürgen

In: Clinical Research in Cardiology, 2008, vol. 97, no. 5, p. 298-305

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    Titre
    • Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock
    Auteur
    • Debrunner, Marianne. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Schuiki, Ernst. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Minder, Elisabeth. Central Laboratory, Stadtspital Triemli, 8063, Zurich, Switzerland
    • Straumann, Edwin. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Naegeli, Barbara. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Mury, Raymond. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Bertel, Osmund. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Frielingsdorf, Jürgen. Division of Cardiology, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Clinical Research in Cardiology, 2008, vol. 97, no. 5, p. 298-305. D. Steinkopff-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:314637
    Summary
    Background: Inflammatory response is an important feature of acute coronary syndromes and myocardial infarction (MI). The prognostic value of proinflammatory cytokines in patients with acute MI complicated by cardiogenic shock is unknown. Methods and results: In 41 patients admitted with acute MI (age 60 ± 11 years, six females, 19 Killip class IV) serial plasma concentration of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and interleukin 1 receptor antagonist (IL-1Ra) were measured. Seven patients with cardiogenic shock (CS) developed a systemic inflammatory response syndrome (SIRS). Patients with CS—particularly those who developed SIRS—showed significantly higher cytokine levels than patients with uncomplicated MI. In patients with CS and SIRS peak levels of IL-1Ra were 223,973 pg/ml, IL-6 252.8 pg/ml and TNF-α 7.0 pg/ml. In CS without SIRS IL-1Ra levels were 19,988 pg/ml, IL-6 109.3 pg/ml and TNF-α 3.8 pg/ml. In uncomplicated MI peak IL-1Ra levels were 1,088 pg/ml, IL-6 34.1 pg/ml and TNF-α 2.6 pg/ml. Conclusions: The inflammation-associated cytokines TNF-α, IL-6 and IL-1Ra are significantly elevated in patients with MI complicated by CS when compared to patients with uncomplicated MI. Among shock-patients IL-1Ra levels are promising diagnostic markers for early identification of patients developing SIRS, heralding a poor outcome