[Temporal changes and interaction of serum cytokines in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention].

OBJECTIVE: To investigate the temporal changes of serum cytokines IL-6, IL-8, MCP-1 and IL-10 immediately before and after primary PCI (percutaneous coronary intervention) in patients with ST-segment elevation myocardial infarction (STEMI) and explore the interaction of these cytokines. METHODS: A total of 59 STEMI patients were recruited. And their serum concentrations of IL-6, IL-8, MCP-1 and IL-10 were measured by ELISA before primary PCI and 4-6 hours, 12 hours, 24 hours and 7 days post-intervention. For each cytokine, the level at each time-point post-PCI was compared to that at pre-PCI. Correlation coefficient test was used to analyze the interactions of these four cytokines. RESULTS: At 12 hours post-PCI, the median serum levels of IL-6 and IL-8 were higher than those before PCI (IL-6: 8.51 ng/L vs 6.76 ng/L, IL-8: 4.67 ng/L vs 2.95 ng/L, both P < 0.05). At 4-6 hours and 12 hours post-PCI, the median values of MCP-1 were increasing significantly compared to those at pre-PCI (35.04 ng/L, 34.24 ng/L vs 30.45 ng/L, both P < 0.05) while those of IL-10 decreased (18.15 ng/L, 18.82 ng/L vs 20.95 ng/L, both P < 0.05). The levels of IL-6 and IL-10 at pre-PCI were associated with the Killip classification on admission (IL-6: r = 0.293, P < 0.05; IL-10: r = -0.287, both P < 0.05). Except for IL-8, other cytokines had no significant relation with the time length from onset to admission (P > 0.05). Additionally, these four cytokines were not found to be related with the location and extension of myocardial infarction, ejection fraction and NT-proBNP. At each time-point, there were a positive relationship among the natural logarithms of the concentrations of IL-6, IL-8 and MCP-1 (P < 0.01), all of which were inverse to the natural logarithm of the concentration of IL-10 (P < 0.01). CONCLUSIONS: The pro-inflammatory cytokines increase while the anti-inflammatory cytokines decrease after myocardial ischemia/reperfusion. An imbalance of inflammatory cytokines may be present.