Chemokine RANTES and IL-1β in mild therapeutic hypothermia-treated patients after out-of-hospital sudden cardiac arrest

Introduction: CCL5/RANTES and IL-1β, which regulate the immune response, may have an impact on survival in patients with acute coronary syndrome (ACS) and sudden cardiac arrest (SCA).Aim: To evaluate levels of CCL5/RANTES and IL-1β in patients with ACS complicated by SCA, treated with coronary angioplasty (PCI) and mild therapeutic hypothermia (MTH), and these chemokines' impact on the 30-and 180-day survival.Material and methods: Thirty-three unconscious patients admitted after SCA with ACS underwent PCI and MTH treatment.CCL5/RANTES and IL-1β were evaluated on admission (T0), at 12-24 h (T1) and at 48-72 h (T2).All-cause mortality was recorded at 30 and 180 days.Results: We observed a statistically significant decrease in median levels of CCL/RANTES at T0, T1 and T2 (24.69 ng/ml vs. 3.89 ng/ml vs. 2.71 ng/ml; p < 0.001), and significant differences in median levels of IL-1β (0.196 pg/ml vs. 0.171 pg/ml vs. 0.214 pg/ml; p = 0.034).Initial levels of CCL5/RANTES and IL-1β correlated significantly (r = -0.360;p = 0.045).At T2, CCL5/RANTES correlated with the maximum levels of hs-TnT and CK-MB (r = -0.594;p < 0.001 and r = -0.389;p = 0.030), and at T0 with BNP (r = -0.521;p = 0.003).Mortality rate at 30 days and 180 days was 18.2% and 45.5%, respectively.At 30 days, we observed a trend to significance for IL-1β at T0 and T1 (p = 0.078 and p = 0.079), but not for CCL5/RANTES (p = 0.284 and p = 0.351).For 180-day survival curves, only the IL-1β level at T1 was associated with mortality (p = 0.028).Conclusions: Although CCL5/RANTES levels correlate with cardiac injury and heart failure markers and they decrease during MTH, they failed to predict early and late mortality.In contrast, IL-1β level was associated with 180-day survival.