Serum levels of interleukin-6, interleukin-10 and C-reactive protein in patients with myocardial infarction treated with primary angioplasty during a 6-month follow-up.

INTRODUCTION: Recent studies indicate that inflammatory and immune factors are involved in the post-infarction cardiac remodeling.

OBJECTIVES: We evaluated serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and C-reactive protein (CRP) in patients with acute coronary syndrome with ST-segment elevation myocardial infarction (STEMI) in the acute phase of the disease and 6 months later. Moreover we sought to determine the effect of selected clinical parameters on the levels of the inflammatory factors.

PATIENTS AND METHODS: The study involved 75 patients with STEMI, aged 36-82 years, treated with primary angioplasty. Blood samples for determination of IL-6, IL-10 and CRP levels were taken on the 3rd and 7th day of hospitalization and after 6 months.

RESULTS: In the acute phase of myocardial infarction (MI) the levels of IL-6, IL-10 and CRP, as well as the IL-6/IL-10 and CRP/IL-10 indexes were higher than in the control group. Six months later the CRP level decreased significantly, and the levels of IL-6 and IL-10 and the studied indices normalized. In the acute phase of MI there were positive correlations between the studied factors. The independent predictors of IL-6, IL-10 and CRP levels were body mass index (BMI), troponin I, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and the baseline levels of inflammatory markers.

CONCLUSIONS: In the acute phase of MI, inflammatory activation is enhanced with predominant proinflammatory response. In the course of the healing process within 6 months inflammation is suppressed and the balance between pro- and anti-inflammatory activation is restored. The size of MI, BMI, lipid levels and the baseline levels of inflammatory markers influence the levels of inflammatory factors.