Document Detail

Tumour necrosis factor-alpha and interleukin-6 release during primary percutaneous coronary intervention for acute myocardial infarction is related to coronary collateral flow.
MedLine Citation:
PMID:  15818083     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We tested the hypothesis that there was an association between tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) release and measured coronary collateral flow in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). BACKGROUND: Tumour necrosis factor-alpha and IL-6 increase during acute myocardial infarction (AMI). However, their relation to coronary collateral flow is unknown. METHODS: Twelve patients with AMI due to complete thrombotic coronary occlusion underwent primary PCI within 12 h of symptom onset. Doppler-derived collateral flow index (CFI) was measured during first balloon inflation. TNF-alpha, IL-6, creatine kinase (CK), CK-MB fraction were measured from venous plasma samples serially for 24 h. Area at risk was determined off-line by coronary arteriography. Ejection fraction (EF) was measured using biplane left ventricular angiography. RESULTS: Maximal CK release varied between 569 and 6276 U/l and area at risk varied between 7 and 47% of myocardium. Tumour necrosis factor-alpha (peak 4.4+/-0.5 pg/ml) and IL-6 (peak 35.5+/-3.0 pg/ml) increased in all patients. Peak TNF-alpha and IL-6 release was independent of CK, CKMB. No minimal threshold of myocardial necrosis for cytokine expression could be detected. Similarly, TNF-alpha and IL-6 release was also independent of time to reperfusion, area at risk or EF. Using univariate regression analysis, peak TNF-alpha inversely correlated with CFI (r = 0.67, P = 0.017) whereas IL-6 positively correlated with CFI (r = 0.76, P = 0.004). CONCLUSIONS: Acute myocardial infarction is associated with a significant rise in TNF-alpha and IL-6 levels independent of infarct size or myonecrosis. Tumour necrosis factor-alpha and IL-6 correlate dichotomously with CFI indicating differing roles in reperfused AMI.
Roby D Rakhit; Christian Seiler; Kerstin Wustmann; Stephan Zbinden; Stephan Windecker; Bernhard Meier; Franz R Eberli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Coronary artery disease     Volume:  16     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-08     Completed Date:  2005-09-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  147-52     Citation Subset:  IM    
Swiss Cardiovascular Centre, University Hospital, Bern, Switzerland.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Collateral Circulation
Coronary Circulation
Creatine Kinase / blood
Interleukin-6 / blood*
Myocardial Infarction / blood*,  therapy*
Regression Analysis
Stroke Volume
Tumor Necrosis Factor-alpha / analysis*
Reg. No./Substance:
0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; EC Kinase

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