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Interleukin-6 and neutrophils are associated with long-term survival after acute myocardial infarction
1Department of Internal Medicine, The Vrinnevi Hospital, Norrköping, Sweden. petter.jaremo@beta.telenordia.se
Insights
Inflammation markers, including interleukin-6 (IL-6) and neutrophil counts, predict long-term survival after acute myocardial infarction (MI). Lower levels of these markers indicate a more favorable prognosis for patients surviving over eight years.
Area of Science:
- Cardiology
- Immunology
- Biomarkers
Background:
- Assessing long-term survival after acute myocardial infarction (MI) is challenging.
- Inflammation is known to predict short-term coronary death.
- The association between inflammation and long-term survival post-MI remains unclear.
Purpose of the Study:
- To evaluate the relationship between long-term survival (over 8 years) and inflammatory markers in acute MI patients.
- Specifically, to assess the prognostic value of circulating interleukin-6 (IL-6) and neutrophil counts.
Main Methods:
- Included patients with ST-segment elevation MI (STEMI) and non-ST-segment MI (non-STEMI) from 1996.
- Measured IL-6 and neutrophil counts within 24 hours of pain onset.
- Followed patients for over 8 years using the national death registry to compare inflammatory markers with long-term survival.
Main Results:
- Survivors of acute MI for over 8 years had lower IL-6 levels (p<0.01) and decreased neutrophil counts (p<0.05) at the time of MI.
- These differences remained significant even when excluding early deaths.
- Lower initial IL-6 levels were strongly associated with a more favorable long-term prognosis (p<0.01).
Conclusions:
- Circulating IL-6 is a significant predictor of long-term survival following acute MI.
- Neutrophil counts also appear to hold prognostic value for long-term outcomes in acute MI patients.
Background:
Assessing acute myocardial infarction (MI) with respect to long-term survival is not easy. Authorities in the field suggest that inflammation predicts short-range (up to 17 months) coronary death. It is not known whether long-term survival is associated with the inflammatory response. In this study, we evaluate the relationships between survival for more than 8 years and inflammation, i.e., circulating interleukin-6 (IL-6) and neutrophil counts, in acute MI.
Methods:
Patients with ST-segment elevation MIs (STEMI; n=33) and non-ST-segment MIs (non-STEMI; n=39) in 1996 were included in the study. All STEMI patients received thrombolytic therapy. Acute coronary angiography was not an option. Determination of IL-6 and neutrophils was carried out within 24 h after commencement of pain. The subjects were followed for more than 8 years (until December 31, 2005) using the national death registry. Inflammatory markers at the time of MI were compared with long-term survival (n=35).
Results:
At the time of acute MI, survivors for more than 8 years proved to have lower IL-6 (p<0.01) and decreased neutrophil counts (p<0.05). The differences remained (p<0.01 for both markers) when excluding deaths (n=11) occurring in 1996 and 1997. Subsequently, the subjects were divided into two equally sized groups, depending on their IL-6 values at the beginning of the study. As expected, a lower IL-6 was associated with a more favorable long-term prognosis (p<0.01).
Conclusions:
Circulating IL-6 predicts long-term survival after acute MI. Neutrophils appear to have prognostic value as well.
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