Authored by Abdel Mohsen Mostafa Aboualia*
Abstract
Background: Atherosclerosis and its complication is proved to be an inflammatory process with increasing evidence of the role of cytokines in atherosclerosis pathophysiology.
Objective: To investigate the predictive role of admission level of interleukin-2 (IL-2) in acute myocardial infarction patients in detecting success of thrombolytic therapy.
Patients and Method: Forty patients with the diagnosis of ST-elevation myocardial infarction (STEMI) (20 patients diagnosed as STEMI with successful thrombolytic therapy and 20 patients diagnosed as STEMI with failed thrombolytic therapy) from those attending the Coronary Care Units in Cardiology department Al Hussein university hospital between April to May 2013 underwent echocardiography and baseline and after 3days follow up of IL-2 level .
Results: The age in STEMI success group was 44.7 ± 9.41 years while in the failed thrombolytic group 58.3 ± 7.93 years, hypertension (HTN) and diabetes mellitus (DM) were more prevalent in STEMI success group while smoking more in thrombolytic failed group. In the present study, Interleukin-2 was 274.3 ± 104.2 pg/ml in STEMI success group and 215.1 ± 49.4 pg/ml in STEMI failed group with no significant difference.
Conclusions: Admission level of serum IL-2 failed to predict the success of thrombolytic therapy
Introduction
Acute coronary syndrome (ACS) is the most common presentation of cardiovascular disease. Sensitive biomarkers improve the diagnosis of ACS among clinician leading to advancement in the management and reduction in mortality [1]. Till this time the superiority of primary percutaneous coronary intervention (PPCI) in those patient is evidence based. ST-elevation myocardial infarction (STEMI) patients presented in COVID-19 era or to hospitals without PCI facilities should receive thrombolytic therapy. Prediction of success is crucial to determine eligibility for thrombolytic therapy. Interleukin-2 (IL-2) has multiple functions, sometimes opposing to each other during an inflammatory response. IL-2 has osteoprotective effect on regulatory cells expansion. Also, IL-2 stimulates natural killer cells to proliferate and induces cytolytic activity when present at high levels and stimulates B cells division and antibody production. So, it has a role in the atherosclerosis inflammatory process and its sequale [2]. Recent studies have shown that IL-2 has an action on atherosclerosis and remodeling after myocardial infarction in mice [3]. But there is lack of results about IL-2 as a predictor of thrombolysis success.
Aim of the Work
To investigate the predictive role of admission level of interleukin-2 (IL-2) in acute myocardial infarction patients in detecting success of thrombolytic therapy.
Patients and Method
This study was included (40) patients with the diagnosis of STEMI from those attending the Coronary Care Units in Cardiology department Al-Hussein university hospital, between April 2013 and August 2013.
The studied population were classified into two equal groups based on thrombolysis success
STEMI success group: ST segment elevation myocardial infarction group with successful thrombolytic therapy which included 20 patients.
STEMI failed group: ST segment elevation myocardial infarction group with failed thrombolytic therapy which included 20 patients.
Exclusion criteria: previous myocardial infarction or coronary intervention in the last three month, active inflammation, or active immunological diseases.
Method
After informed consent was taken, all patients underwent the following: -
1. Detailed history with special emphasis on: Age and gender, smoking, diabetes mellitus, hypertension, and dyslipidemia.
2. Clinical (general, cardiac) examination.
3. Laboratory work up including
a) Cardiac enzyme creatine kinase-myocardial band (CKMB) and troponin I to diagnose STEMI.
b) Serum interleukin-2: by ELISA at time of admission and after 7 days (Orgenium Laboratories’ Tiilitie 3 FIN-01720 Vantaa FINLAND).
4. Resting 12 leads ECG to diagnose TSEMI based on fourth universal definition of myocardial infarction [4].
5. Resting conventional trans-thoracic echocardiography at time of admission with the patients in the left lateral decubitus. Images were obtained using Philips IE 33 X machine. Recordings and calculations of Aortic root, Left atrium dimension, internal measurements of the LV and LV systolic function using biplane modified Simpson’s methods [5].
6. The patients were classified according to the success of thromboolysis identified by – resolution of chest pain, accelerated idio-ventricular rhythm (AIVR), and ST segment Resolution (STR) >50% in the lead with maximum ST elevation in pre-Thrombolytic ECG after 2 hours of streptokinase infusion [6].
7. Statistical Analysis of the Data The data were analyzed statistically using IBM-SPSS-22 (Statistical Package for Social Science version 22). Means and standard deviation were used to describe data distribution. t-test was used for comparison between groups. The test was considered significant if the probability (p-value) was less than 0.05.
Result
The clinical findings of the patients
Age
The age was lower in STEMI success group than STEMI failed group (44.5±8.41 versus 58.2±4.63 years) and this difference is statistically significant (p value = 0.01) (Table 1).
To read more about this article....Open access Journal of Cardiology Research & Reports
Please follow the URL to access more information about this article
To know more about our Journals...Iris Publishers
No comments:
Post a Comment