Study the Value of Interleukin-6 as Diagnostic Marker and Pridective of Cardiac Events in ST Segment Elevation Myocardial Infarction

Introduction: Interleukin-6 (IL-6) is an inflammatory cytokine produced by endothelial cells, smooth muscle cells, fibroblasts, lymphocytes and macrophages. Atherosclerosis is currently considered a systemic inflammatory disease and elevated levels of IL-6 have been associated with the progression of coronary artery disease (CAD). Patients with ST segment myocardial infarction have increased circulating levels of IL-6 compared with those patients who have stable angina. Aim of Work: To assess the diagnostic value of interleukin 6 compared to troponin I in ST segment elevation MI. To assess the predictive value of elevated interleukin 6 in ST segment elevation myocardial infarction. Methods: This prospective study was included sixty adult patients of both sex meeting the American Heart Association (AHA) recommendations for diagnosis of ST segment elevation myocardial infarction from those attending the Critical Care Units, Critical Care Medicine Department, Faculty of Medicine, Alexandria University. Patients were classified into the following groups: Patient Group I: ST segment elevation myocardial infarction: Group IA: with successful thrombolytic therapy. Group IB: with failed thrombolytic therapy. Control group II: The study will also include ten healthy control patients of same age and sex. Then each patient had been subjected to the following: Cardiac enzymes: creatine kinase-myocardial band (CK-MB) (ng/ml) and troponin I (ng/ml) once on admission using dimension RxL Siemens. Enzyme-linked immunosorbent assay (ELISA) for quantitative detection of human IL-6(pg/ml) in the serum once on admission. Results: There was significant statistical difference between group I (Patient group) and control group as regard to troponin I level (p< 0.001). Interleukin-6 was showed significant increase in group IA and it was ranged from 105 pg/ml to 634 pg/ml with mean 346.9 pg/ml which was higher than group IB, Also Interleukin-6 was showed significant increase in group IB and it was ranged from 134– 590 pg/ml with mean 293 pg/ml, While in group II (Control group) it was ranged from 2.30 to 5.90 pg/ml with mean 4.04 pg/ml. So there was significant statistical difference between both group I and control group as regard to interleukin-6 level (p <0.001). Also there was significant statistical difference between both group I and control group as regard to CK-MB level (p <0.001). Conclusion: STEMI patients have increased level of IL-6 compared to those normal persons. IL-6 may be a potentially useful marker for diagnosis of STEMI. IL-6 may be helpful prognostic value for future cardiac mortality in patients with STEMI. The level of IL-6 is not affected by the extent of myocardial damage and necrosis. [Akram Muhammad Fayed, Muhammad Nasr Eldeen Elsayed, Atef Abd El Aziz Mahros, Mona Wagdy Ayad, Soliman Ahmed Soliman. Study the Value of Interleukin-6 as Diagnostic Marker and Pridective of Cardiac Events in ST Segment Elevation Myocardial Infarction. J Am Sci 2015;11(11):132-143]. (ISSN: 1545-1003). http://www.jofamericanscience. org. 14. doi:10.7537/marsjas111115.14.