Systemic inflammation and reperfusion injury in patients with acute myocardial infarction

被引:56
作者
Blancke, F
Claeys, MJ
Jorens, P
Vermeiren, G
Bosmans, J
Wuyts, FL
Vrints, CJ
机构
[1] Univ Antwerp, Univ Antwerp Hosp, Dept Cardiol, B-2650 Edegem, Belgium
[2] Univ Antwerp, Univ Antwerp Hosp, Dept Intens Care Med, B-2650 Edegem, Belgium
[3] Univ Antwerp, Univ Antwerp Hosp, Dept Biomed Phys & Biostat, B-2650 Edegem, Belgium
关键词
D O I
10.1155/MI.2005.385
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
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-alpha) 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-alpha 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-alpha 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-alpha level and the total ischemic time (P = .8) or the extent of jeopardized myocardium (P = .6). Systemic inflammation, in particular high levels of TNF-alpha, is strongly associated with the occurrence of reperfusion injury after successful recanalization. Our findings suggest that TNF-alpha is involved in the triggering and/or amplification of local inflammatory responses related to ischemia-reperfusion injury.
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页码:385 / 389
页数:5
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