Increased interleukin-1β levels are associated with left ventricular hypertrophy and remodelling following acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention

. Ørn S, Ueland T, Manhenke C, Sandanger Ø, Godang K, Yndestad A, Mollnes TE, Dickstein K, Aukrust P (Stavanger University Hospital, Stavanger; Oslo University Hospital Rikshospitalet; University of Bergen, Bergen; University of Oslo; Oslo; Norway). Increased interleukin‐1β levels are associated with left ventricular hypertrophy and remodelling following acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention. J Intern Med 2012; 272: 267–276. Objectives. To assess the relationship between interleukin (IL)‐1‐related molecules, infarct size and left ventricular (LV) remodelling following acute myocardial infarction (MI). Methods. Forty‐two patients with first‐time diagnosis of ST segment elevation MI (STEMI), with a single occluded vessel successfully revascularized by primary percutaneous coronary intervention (PCI), were recruited to this observational study conducted at a university teaching hospital and followed for 1 year. Main outcome measures. Plasma levels of IL‐1β, IL‐1 receptor antagonist (IL‐1Ra), IL‐18 and caspase‐1 were analysed before and 2 days, 1 week and 2 months after PCI. Serial cardiac magnetic resonance imaging (CMR) was used for the assessment of infarct size and LV remodelling. CMR findings at 1 year was the primary outcome variable. Results. Univariate analysis showed that IL‐1‐related mediators were strongly (IL‐1 β), moderately (caspase‐1) and weakly (IL‐1Ra) associated with impaired myocardial function and noninfarct mass, but not infarct size, 1 year after reperfused STEMI. In multivariate analyses, troponin T predicted LV ejection fraction (LVEF), infarct size and LV end‐diastolic (LVEDVi) and end‐systolic volume index (LVESVi). However, significant additional variance was explained by IL‐1β, IL‐18 and caspase‐1. IL‐1β levels at 2 months, IL‐18 at 2 days and pre‐PCI caspase‐1 were predictors of LVEF. Caspase‐1 and in particular IL‐1β at 2 days were the only predictors of noninfarct mass. IL‐1β and IL‐18 at 2 days were predictors of LVEDVi, whilst pre‐PCI levels of IL‐1β contributed to prediction of LVESVi. By contrast, pro‐B‐type natriuretic peptide, C‐reactive protein, IL‐6 and transforming growth factor‐β1 (TGF‐β1) had no or only a weak (TGF‐β1) association with these CMR parameters in multivariate analyses. Conclusions. IL‐1β levels after STEMI were strongly associated with impaired myocardial function and noninfarct LV mass after 1 year, suggesting a potential role for IL‐1