Release Kinetics of Inflammatory Biomarkers in a Clinical Model of Acute Myocardial Infarction
Rationale: Inflammation in the setting of acute myocardial infarction (AMI) has been linked to risk stratification; however, the release kinetics of inflammatory biomarkers in patients with AMI has been difficult to establish.
Objective: The aim of this study was to determine the kinetics of changes in the levels of a number of biomarkers specifically linked to inflammation following transcoronary ablation of septal hypertrophy (TASH), a procedure that mimics AMI.
Methods and Results: We analyzed release kinetics of C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), interleukin 6 (IL-6), soluble CD40 ligand (sCD40L) and peripheral blood leukocyte subsets in patients (n=21) undergoing TASH. Blood samples were collected prior to TASH and at various times after TASH. Serum levels of CRP were increased at 24 h (1.0 mg/dL [IQR 0.7-1.75] vs. 0.2 mg/dL [IQR 0.1-1.05] at BL; p<0.001), whereas hs-CRP increased as early as 8 h (2.68 mg/L [IQR 1.23-11.80] vs. 2.17 mg/L [IQR 1.15-5.06] at BL; p=0.002). IL-6 was significantly increased at 45 min (2.59 pg/mL [IQR 1.69-5.0] vs. 1.5 pg/mL [IQR 1.5-2.21] at BL; p=0.002), and sCD40L was significantly decreased at 60 min (801.6 pg/mL [IQR 675.0-1653.5] vs. 1750.0 pg/mL [IQR 1151.0-2783.0] at BL; p=0.016). Elevated counts of polymorphonuclear neutrophils were detectable at 15 min, with a significant increase at 2 h (6415 cells/µL [IQR 5288-7827] vs. 4697 cells/µL [IQR 2892-5620] at BL; p=0.004). Significant monocytosis was observed at 24 h (729 cells/µL [IQR 584-1344] vs. 523 cells/µL [IQR 369-701] at BL; p=0.015).
Conclusions: IL-6 and neutrophil granulocytes showed a continuous rise at all pre-specified time points after induction of myocardial infarction. Our results provide valuable additional evidence of the diagnostic value of inflammatory biomarkers in the setting of early AMI.
- Received June 20, 2014.
- Revision received December 3, 2014.
- Accepted December 16, 2014.