Systemic Inflammation and Reperfusion Injury in Patients With Acute Myocardial Infarction
Despite early recanalization of an occluded infarct artery, tissue reperfusion remains impaired in more than one-third of the acute myocardial infarction (AMI) patients owing to a process of reperfusion injury. The role of systemic inflammation in triggering this phenomenon is unknown. Proinflammato...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2005-01-01
|
| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/MI.2005.385 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841524680412889088 |
|---|---|
| author | Fien Blancke Marc J. Claeys Philippe Jorens Guy Vermeiren Johan Bosmans Floris L. Wuyts Chris J. Vrints |
| author_facet | Fien Blancke Marc J. Claeys Philippe Jorens Guy Vermeiren Johan Bosmans Floris L. Wuyts Chris J. Vrints |
| author_sort | Fien Blancke |
| collection | DOAJ |
| description | Despite early recanalization of an occluded infarct artery,
tissue reperfusion remains impaired in more than one-third of the
acute myocardial infarction (AMI) patients owing to a process of
reperfusion injury. The role of systemic inflammation in
triggering this phenomenon is unknown. Proinflammatory factors
(hs-CRP, TNF-α) and anti-inflammatory mediators
(IL-1 receptor antagonist, IL-10) were measured in 65 patients
during the acute phase of a myocardial infarction as well as in
11 healthy control subjects. Myocardial reperfusion injury was
defined as the presence of persistent ST-segment elevation
despite successful coronary intervention (≥50% of the
initial value) and was observed in 28 patients. Systemic
proinflammatory mediators (particularly hs-CRP and leukocytes)
were higher in AMI patients compared to control
subjects. Within the group of AMI patients, only serum
TNF-α differed significantly between patients with versus
without reperfusion injury: a median value of 25 versus
13 pg/mL was observed, respectively. Logistic regression
analysis identified a high level of TNF-α as the most
important independent determinant of reperfusion injury
(P=.001), beyond total ischemic time (P=.01) and extent of
jeopardized myocardium (P=.08). There was no correlation
between the TNF-α level and the total ischemic time
(P=.8) or the extent of jeopardized myocardium (P=.6).
Systemic inflammation, in particular high
levels of TNF-α, is strongly associated with the
occurrence of reperfusion injury after successful recanalization.
Our findings suggest that TNF-α is involved in the
triggering and/or amplification of local inflammatory responses
related to ischemia-reperfusion injury. |
| format | Article |
| id | doaj-art-3c0d599c12234ec8b77a5703d3a5f7d3 |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2005-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-3c0d599c12234ec8b77a5703d3a5f7d32025-02-03T05:47:36ZengWileyMediators of Inflammation0962-93511466-18612005-01-012005638538910.1155/MI.2005.385Systemic Inflammation and Reperfusion Injury in Patients With Acute Myocardial InfarctionFien Blancke0Marc J. Claeys1Philippe Jorens2Guy Vermeiren3Johan Bosmans4Floris L. Wuyts5Chris J. Vrints6Department of Cardiology, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDepartment of Cardiology, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDepartment of Intensive Care Medicine, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDepartment of Cardiology, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDepartment of Cardiology, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDepartment of Biomedical Physics and Biostatistics, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDepartment of Cardiology, Antwerp University Hospital, University of Antwerp (UA), Wilrijkstraat 10, Edegem, 2650, BelgiumDespite early recanalization of an occluded infarct artery, tissue reperfusion remains impaired in more than one-third of the acute myocardial infarction (AMI) patients owing to a process of reperfusion injury. The role of systemic inflammation in triggering this phenomenon is unknown. Proinflammatory factors (hs-CRP, TNF-α) and anti-inflammatory mediators (IL-1 receptor antagonist, IL-10) were measured in 65 patients during the acute phase of a myocardial infarction as well as in 11 healthy control subjects. Myocardial reperfusion injury was defined as the presence of persistent ST-segment elevation despite successful coronary intervention (≥50% of the initial value) and was observed in 28 patients. Systemic proinflammatory mediators (particularly hs-CRP and leukocytes) were higher in AMI patients compared to control subjects. Within the group of AMI patients, only serum TNF-α differed significantly between patients with versus without reperfusion injury: a median value of 25 versus 13 pg/mL was observed, respectively. Logistic regression analysis identified a high level of TNF-α as the most important independent determinant of reperfusion injury (P=.001), beyond total ischemic time (P=.01) and extent of jeopardized myocardium (P=.08). There was no correlation between the TNF-α level and the total ischemic time (P=.8) or the extent of jeopardized myocardium (P=.6). Systemic inflammation, in particular high levels of TNF-α, is strongly associated with the occurrence of reperfusion injury after successful recanalization. Our findings suggest that TNF-α is involved in the triggering and/or amplification of local inflammatory responses related to ischemia-reperfusion injury.http://dx.doi.org/10.1155/MI.2005.385 |
| spellingShingle | Fien Blancke Marc J. Claeys Philippe Jorens Guy Vermeiren Johan Bosmans Floris L. Wuyts Chris J. Vrints Systemic Inflammation and Reperfusion Injury in Patients With Acute Myocardial Infarction Mediators of Inflammation |
| title | Systemic Inflammation and Reperfusion Injury in Patients With Acute
Myocardial Infarction |
| title_full | Systemic Inflammation and Reperfusion Injury in Patients With Acute
Myocardial Infarction |
| title_fullStr | Systemic Inflammation and Reperfusion Injury in Patients With Acute
Myocardial Infarction |
| title_full_unstemmed | Systemic Inflammation and Reperfusion Injury in Patients With Acute
Myocardial Infarction |
| title_short | Systemic Inflammation and Reperfusion Injury in Patients With Acute
Myocardial Infarction |
| title_sort | systemic inflammation and reperfusion injury in patients with acute myocardial infarction |
| url | http://dx.doi.org/10.1155/MI.2005.385 |
| work_keys_str_mv | AT fienblancke systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction AT marcjclaeys systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction AT philippejorens systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction AT guyvermeiren systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction AT johanbosmans systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction AT florislwuyts systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction AT chrisjvrints systemicinflammationandreperfusioninjuryinpatientswithacutemyocardialinfarction |