Level and Value of Interleukin-18 in Patients With Acute Myocardial Infarction Undergoing Primary Coronary Angioplasty

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概要

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• Background The prognostic value of interleukin (IL)-18 in patients with ST-segment elevation acute myocardial infarction (STEMI) is currently unclear. Thus, the purpose of this study was to test whether the circulating IL-18 level can predict prognosis in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Methods and Results A prospective cohort study was conducted with 267 consecutive patients with STEMI of onset <12h who were undergoing primary PCI. Blood samples for plasma IL-18 level were collected in the catheterization laboratory following vascular puncture. The plasma IL-18 level was also evaluated in 25 healthy and 30 at-risk control subjects. The plasma level of IL-18 was significantly higher in acute myocardial infarction (AMI) patients than in both groups of control subjects (all p<0.0001). Patients with high plasma IL-18 level (⪈560pg/ml) had significantly higher peak creatine kinase-MB levels, higher incidence of cardiogenic shock upon presentation, significantly lower left ventricular ejection fraction (LVEF), lower successful reperfusion and significantly higher incidence of 30-day composite major adverse clinical events (MACE) (advanced congestive heart failure >class 3 or 30-day mortality) than those patients with low plasma IL-18 level (<560pg/ml) (all p<0.0001). Multiple stepwise logistic regression analysis demonstrated that high plasma IL-18 level (⪈560pg/ml) along with low LVEF (<50%) and cardiogenic shock were the most independent predictors of 30-day MACE (p<0.0001). Conclusions In patients with STEMI, plasma IL-18 level is a major independent inflammatory predictor of 30-day MACE. Evaluation of circulating IL-18 might improve the prediction of unfavorable clinical outcomes following AMI.

• 社団法人日本循環器学会の論文
• 2007-04-20

著者

• YIP Hon-Kan

  Division of Cardiology, Department of Internal Medicine

• CHAI Han-Tan

  Division of Cardiology, Department of Internal Medicine

• YOUSSEF Ali

  Cardiology Department, Suez Canal University Hospital

• YANG Cheng-Hsu

  Division of Cardiology, Department of Internal Medicine

• HANG Chi-Ling

  Division of Cardiology, Department of Internal Medicine

• CHANG Li-Teh

  Division of Basic Medical Science, Department of Nursing, Meiho Institute of Technology

• Wu Chiung-Jen

  Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medi

• Cheng Cheng-i

  Graduate Institute Of Clinical Medical Sciences Chang Gung University College Of Medicine

• Wu Chiung-jen

  Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica

• Wu Chiung-jen

  Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University College Of Medicine

• Cheng Cheng-I

  Division of Cardiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University

• Chua Sarah

  Division of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine

• Yeh Kuo-Ho

  Division of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine

• Yang Cheng-Hsu

  Chang Gung University College of Medicine

• Yip Hon-Kan

  Chang Gung University College of Medicine

• Chai Han-tan

  Division Of Cardiology Department Of Internal Medicine

• Chua Sarah

  Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital

• Yeh Kuo-ho

  Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital

• Yip Hon-kan

  Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica

• Youssef Ali

  Cardiology Department Suez Canal University Hospital

• Sheu Jiunn-Jye

  Department of Cardiovascular Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang G

• Yang Cheng-hsu

  Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica

• Yang Cheng-hsu

  Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University College Of Medicine

• Chang Li-teh

  Basic Science Nursing Department Meiho Institute Of Technology

• Sheu Jiunn-jye

  Division Of Cardiology Department Of Cardiovascular Surgery Chang Gung Memorial Hospital-kaohsiung M

• Yip Hon-kan

  Division Of Cardiology Department Of Neurology Chang Gung Memorial Hospital-kaohsiung Medical Center

• Hang Chi-ling

  Division Of Cardiology Department Of Internal Medicine

• Hang Chi-ling

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

• Cheng Cheng-i

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

• Wu Chiung-jen

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

• Sheu Jiunn-jye

  Department Of Cardiovascular Surgery Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gun

• Yang Cheng-hsu

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

• Chai Han-tan

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

• Chua Sarah

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

• Yip Hon-kan

  Division Of Cardiology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University C

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