Key result
High plasma IL-6 concentrations (≥17 ng/L) on Day 2 after STEMI were independently associated with adverse left ventricular remodelling at 4 months (OR 2.72; 95% CI 1.06-6.98; P=0.038).
Why the study?
Little was known about the clinical relevance of interleukin-6 in patients with acute STEMI, particularly regarding infarct size, reperfusion injury, and adverse left ventricular remodelling.
Are high plasma IL-6 concentrations associated with larger infarct size, reperfusion injury, and adverse left ventricular remodelling in STEMI patients treated with primary PCI?
Cohort (n=170)
Are high plasma IL-6 concentrations associated with larger infarct size, reperfusion injury, and adverse left ventricular remodelling in STEMI patients treated with primary PCI?
Odds Ratio: 2.72 (95% CI 1.06–6.98)
Absolute Event Rate: 24% vs 9%
p-value: p=0.038
High plasma IL-6 levels on day 2 after STEMI are independently associated with larger infarct size, more severe reperfusion injury, and a higher likelihood of adverse left ventricular remodeling.
May guide post-STEMI risk stratification for remodelling; leaves open whether IL-6 is a modifiable therapeutic target.
AIMS: Little is known about the clinical relevance of interleukin (IL)-6 in patients with acute ST-elevation myocardial infarction (STEMI). This study examined the possible associations of plasma IL-6 concentrations with infarct size (IS), reperfusion injury and adverse left ventricular remodelling (LVR), in STEMI patients treated with primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: We prospectively included 170 consecutive STEMI patients (median age 57 years, 14% women) treated with primary PCI between 2017 and 2019. Blood samples for biomarker analyses including IL-6 were collected on Day 2. Left ventricular ejection fraction (LVEF), IS, and reperfusion injury [microvascular obstruction (MVO) and intramyocardial haemorrhage (IMH)] were determined using cardiac magnetic resonance (CMR) imaging on Day 4. Left ventricular remodelling was defined as ≥10% increase in left ventricular end-diastolic volume from baseline to 4 months CMR follow-up. Patients with IL-6 concentrations ≥median (17 ng/L) showed a significantly lower LVEF (43% vs. 52%, P < 0.001), larger IS (22% vs. 13%, P < 0.001), larger MVO (1.9% vs. 0.0%, P < 0.001), and more frequent IMH (52% vs. 18%, P < 0.001). Left ventricular remodelling was more common in patients with IL-6 ≥ median (24% vs. 9%, P = 0.005). In both linear and binary multivariable regression analyses, IL-6 remained independently associated with lower LVEF [odds ratio (OR): 0.10, 95% confidence interval (CI) 0.02-0.42, P = 0.002], larger IS (OR: 5.29, 95% CI 1.52-18.40, P = 0.009), larger MVO (OR: 5.20, 95% CI 1.30-20.85, P = 0.020), with presence of IMH (OR: 3.73, 95% CI 1.27-10.99, P = 0.017), and adverse LVR (OR: 2.72, 95% 1.06-6.98, P = 0.038). CONCLUSIONS: High concentrations of circulating plasma IL-6 on Day 2 after STEMI were independently associated with worse myocardial function, larger infarct extent, more severe reperfusion injury, and a higher likelihood for LVR, suggesting IL-6 as a useful biomarker of more serious outcome and potential therapeutic target. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT04113356;NCT04113356.
No takes yet. Share an insight, caveat, or question.
Tiller et al. (2021) conducted a cohort in Acute ST-elevation myocardial infarction (STEMI) (n=170). High plasma interleukin-6 (IL-6) concentrations (≥17 ng/L) vs. Low plasma IL-6 concentrations (<17 ng/L) was evaluated on Adverse left ventricular remodelling (LVR) (OR 2.72, 95% CI 1.06-6.98, p=0.038). High plasma IL-6 concentrations (≥17 ng/L) on Day 2 after STEMI were independently associated with adverse left ventricular remodelling at 4 months (OR 2.72; 95% CI 1.06-6.98; P=0.038).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: