C-reactive Protein, Interleukin 6 And Acute Myocardial Infarction Cardiac Dysfunction Related Research

Objective: Through detecting C-reactive protein(CRP) and interleukin-6(IL-6) in serum level of patients with coronary heart disease(CHD),explore the correlation of CRP , IL-6 with heart failure after acute myocardial infarction(AMI),and provide the clue for deeply investigating the inflammatory pathogenesis of CHD. Methods: This study was carried out in 48 cases of AMI(AMI group), 20 of unstable angina (UA)(UA group), and 20 age matched normal controls. The level of serum CRP was determined by serum lipids and IL-6 by radioimmunoassay.CRP and IL-6 were detected on the 1st,3rd and 7th day after admission in AMI group(called CRP₁,CRP₃,CRP₇ and IL-6₁,IL-6₃,IL-6₇ on the 1st,3rd and 7th day respectively), while detected only once in UA group and controls. Outcome measured inclued clinical episodes of heart failure(HF) after AMI and/or echocardiographic evidence of contratile dysfunction. We divided the patients with AMI into 2 subgroups according to the Killip classification(Killlip classâ… namely not HF group and Killip class>â… namely HF group). Results: 1.The level of serum CRP and IL-6 were significantly higher in the patients with AMI(each time: CRP1,IL-6₁,CRP₃,IL-6₃,CRP₇, IL-6₇ ) and UA than that in the controls(P<0.05 respectively), but no differences were found between AMI group(CRP₁ , IL-6₁, CRP₇ , IL-6₇) and UA group(P>0.05 respectively) except CRP₃,IL-6₃( P<0.05 respectively). 2.Among AMI group,CRP and IL-6 of three times were all high and peak on the 3rd day (P<0.05, P<0.05, P<0.05 on the 1st,3rd and 7th day respectively). 3. In AMI group, CRP was higher in patients with HF than that in patients without HF (CRP adjusted P<0.05, P<0.05, P<0.05 on the 1st, 3rd and 7th day respectively). 4.AMI group IL-6 was higher in patients with HF than that in patients without HF (IL-6 adjusted P<0.005,P<0.005,P<0.005 on the 1st, 3rd and 7th day respectively) 5.Multiple linear regression analysis revealed a significant association between left ventricular ejection fraction(EF) and CRP1, coronary recanalization, CRP7. 6.The peak of CRP was not correlated with CK,CK-MB(P=0.713,P=0.936 respectively). 7.The peak of IL-6 was not correlated with CK, CK-MB (P=0.877,P=1.000 respectively). 8.Logistic regression analysis, the affective factors to HF after AMI were coronary recanalization and CRP₁. Conclusion: Inflammation takes part in the course of CHD.CRP and IL-6 level may become an important index for monitoring patient's condition and prognosis of suffering from AMI.