Association of Interleukin 8 and Myocardial Recovery in Patients with ST-Elevation Myocardial Infarction Complicated by Acute Heart Failure |
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| Authors: | Trygve Husebye Jan Eritsland Harald Arnesen Reidar Bj?rnerheim Arild Mangschau Ingebj?rg Seljeflot Geir ?ystein Andersen |
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| Affiliation: | 1. Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.; 2. Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway.; 3. Center for Heart Failure Research, University of Oslo, Oslo, Norway.; 4. Faculty of Medicine, University of Oslo, Oslo, Norway.; Johns Hopkins University SOM, United States of America, |
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| Abstract: | BackgroundNo data from controlled trials exists regarding the inflammatory response in patients with de novo heart failure (HF) complicating ST-elevation myocardial infarction (STEMI) and a possible role in the recovery of contractile function. We therefore explored the time course and possible associations between levels of inflammatory markers and recovery of impaired left ventricular function as well as levosimendan treatment in STEMI patients in a substudy of the LEvosimendan in Acute heart Failure following myocardial infarction (LEAF) trial.MethodsA total of 61 patients developing HF within 48 hours after a primary PCI-treated STEMI were randomised double-blind to a 25 hours infusion of levosimendan or placebo. Levels of IL-6, CRP, sIL-6R, sgp130, MCP-1, IL-8, MMP-9, sICAM-1, sVCAM-1 and TNF-α were measured at inclusion (median 22 h, interquartile range (IQR) 14, 29 after PCI), on day 1, day 2, day 5 and 6 weeks. Improvement in left ventricular function was evaluated as change in wall motion score index (WMSI) by echocardiography.ResultsOnly circulating levels of IL-8 at inclusion were associated with change in WMSI from baseline to 6 weeks, r = ÷0.41 (p = 0.002). No association, however, was found between IL-8 and WMSI at inclusion or peak troponin T. Furthermore, there was a significant difference in change in WMSI from inclusion to 6 weeks between patients with IL-8 levels below, compared to above median value, ÷0.44 (IQR÷0.57, ÷0.19) vs. ÷0.07 (IQR÷0.27, 0.07), respectively (p<0.0001). Levosimendan did not affect the levels of inflammary markers compared to control.ConclusionHigh levels of IL-8 in STEMI patients complicated with HF were associated with less improvement in left ventricular function during the first 6 weeks after PCI, suggesting a possible role of IL-8 in the reperfusion-related injury of post-ischemic myocardium. Further studies are needed to confirm this hypothesis.Trial RegistrationClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00324766","term_id":"NCT00324766"}}NCT00324766 |
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