Dynamics of Interleukin-6 Levels as an Early Marker of Inflammatory Response after Coronary Revascularization in Patients with Acute Coronary Syndrome

The purpose of the study was to check the dynamics of the level of interleukin-6 (IL-6) as an early marker of inflammatory response after coronary revascularization in patients with acute coronary syndrome (ACS). Material and methods. The study included 43 patients undergoing stent implantation for ACS due to myocardial infarction (MI) (18 men and 5 women, 61.3-82.1 years old, an average of 69.0 ± 7.4 years old), and unstable angina (UA) (15 men and 5 women aged 61.7-77.2, on average 68.3 ± 6.9 years old). The determination of the distribution of CRP and IL-6 values was evaluated before the procedure, at 10th and 60th minutes. Results and discussion. The obtained data showed that the dynamics of CRP level during the first postoperative hour in the groups of patients with UA and MI did not show statistically significant changes (p> 0.5). On the contrary, changes in the values of IL-6 were reliable: in patients with UA, 10 minutes after the stent implantation, the level of IL-6 increased by 18.5±1.7% (p=0.0134), and 1 hour after stent implantation its value exceeded the baseline of 28.97±1.7% (p=0.00129); in patients with MI 1 hour after coronary revascularization, IL-6 values increased by 37.8±2.4% (р=0.00133). At the first day of observation, in patients with cardiogenic shock (CS), IL-6 values were on average 36.8±1.68% higher compared to similar values in the group of patients with non-haemodynamic impairment of AMI (p=0.0127). At the 10th day after AMI, in patients with a history of AMI having been complicated by CS, there was a tendency for IL-6 values to increase by 28.2±1.8% on average. And in relation to the values of the level of this interleukin, which was observed in patients with uncomplicated flow, its rates were higher at 19.83±2.04% (p=0.00127). The one-dimensional logistic regression analysis of indices associated with 90-day mortality in the study groups showed that the most significant independent predictors of fatal outcome were: IL-6 (OR=17.58; 95% CI=6.47-47.48; p=0.00012); cardiogenic shock (OR=16.85; 95% CI=6.51-43.49; p=0.00011); ejection fraction (OR=20.81; 95% CI=5,95-72.21; p=0.00014), functional class for NYHA (OR=25.51; 95% CI=8.27-79.12; p=0.00013). Conclusions. Thus, the obtained data allow us to conclude on the diagnostic value of IL-6 indices for the characterization of the clinical course of AMI: values of IL-6 in the range of 39.75±2.1 pg/ml were characteristic for patients with the clinical course of AMI complicated by cardiogenic shock.