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Interleukin-21 - A biomarker of importance in predicting myocardial function following acute infarction?
Weir, Robin A. P. Miller, Ashley M. Petrie, Colin J. Clements, Suzanne Steedman, Tracey Dargie, Henry J. Squire, Iain B. Ng, Leong L. McInnes, Iain B. McMurray, John J. V.
Weir, Robin A. P.
Miller, Ashley M.
Petrie, Colin J.
Clements, Suzanne
Steedman, Tracey
Dargie, Henry J.
Squire, Iain B.
Ng, Leong L.
McInnes, Iain B.
McMurray, John J. V.
Abstract
Introduction: Following acute myocardial infarction (AMI), the acute inflammatory response contributes to wound healing but also to progressive myocardial injury. Interleukin-21 (IL-21) plays a key role in immunoregulation; whether IL-21 is associated with left ventricular (LV) remodelling after AMI is unknown. Methods: Plasma IL-21 concentrations were measured in 100 patients (age 58.9 ± 12.0 years, 77% male) admitted with AMI and LV dysfunction, at baseline (mean 46 h) and again at 24 weeks; cardiac magnetic resonance and measurement of B-type natriuretic peptide, monocyte chemoattractant protein-1, matrix metalloproteinase (MMP)-2, -3, -9, and tissue inhibitor of metalloproteinase (TIMP)-1, -2, -4 occurred at both time-points. Remodelling was defined as change in LV end-systolic volume index (ΔLVESVI). Results: Plasma IL-21 concentration was unchanged over time (48.1 [SD 35.4] pg/mL at baseline vs. 48.8 [61.3] pg/mL at 24 weeks, p = 0.92). Baseline IL-21 correlated significantly with ΔLVESVI (r = 0.30, p = 0.005) and change in LV end-diastolic volume index (r = 0.33, p = 0.003). On multivariate analysis, plasma IL-21 was an independent predictor of remodelling. IL-21 was also significantly associated with higher TIMP-4 concentrations and lower MMP-9 concentrations at baseline. Conclusions: IL-21 predicts adverse remodelling following AMI in patients with LV dysfunction. Whether it plays a direct pathophysiological role in remodelling merits further study.
Keywords
cytokines, acute myocardial infarction, cardiac magnetic resonance imaging
Date
2012
Type
Journal article
Journal
Cytokine
Book
Volume
60
Issue
1
Page Range
220-225
Article Number
ACU Department
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Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled