Santoro Francesco, Tarantino Nicola, Ferraretti Armando, Ieva Riccardo, Musaico Francesco, Guastafierro Francesca, Di Martino Luigi, Di Biase Matteo, Brunetti Natale Daniele
University of Foggia, Foggia, Italy; Asklepios Sankt Georg Klinik, Hamburg, Germany.
University of Foggia, Foggia, Italy.
Atherosclerosis. 2016 Nov;254:28-34. doi: 10.1016/j.atherosclerosis.2016.09.012. Epub 2016 Sep 10.
Systemic inflammation has been hypothesized as a possible mechanism of Takotsubo cardiomyopathy (TTC). Aim of the study was to assess the role of interleukin (IL)-6 and IL-10 in subjects with an episode of TTC.
Fifty-six consecutive subjects with TTC were prospectively enrolled in the study and followed for a mean of 178 days. Circulating levels of IL-6, IL-10, clinical condition and left ventricular ejection fraction were evaluated at admission. Incidence of death, re-hospitalization and recurrence of TTC during follow-up was also recorded.
23% of patients experienced in-hospital complications while 20% of patients had adverse events at follow-up. IL-6 and IL-10 serum levels at admission were higher in subjects with adverse events at follow-up (120 ± 294 vs. 22 ± 40 pg/ml, p<0.05; 13 ± 35 vs. 2 ± 3 pg/ml, p=0.05, respectively). Increased serum levels of IL-6 and IL-10 were associated with higher adverse events rates at follow-up (Log-Rank p<0.001, <0.05, hazard ratio 8.6, 5.1, respectively) and mortality rates (Log-Rank p<0.001, p<0.05, hazard ratio 20.8, 7.1, respectively). Subjects with both increased IL-6 and IL-10 levels were characterized by an increased risk of adverse events when compared to subjects with only IL-6 or IL-10 increased levels or with values below cutoff values (Log-Rank p<0.01 for any event, <0.001 for death; hazard ratio 1.20 for any event, 1.31 for death), even after correction for age, LVEF and NTproBNP levels in multivariable Cox analysis.
Serum IL-6 and IL-10 admission levels are associated with higher risk of adverse events during follow-up.
全身性炎症被认为是应激性心肌病（TTC）的一种可能机制。本研究的目的是评估白细胞介素（IL）-6和IL-10在TTC发作患者中的作用。
前瞻性纳入56例连续的TTC患者，平均随访178天。入院时评估IL-6、IL-10的循环水平、临床状况和左心室射血分数。记录随访期间的死亡、再次住院和TTC复发的发生率。
23%的患者发生院内并发症，20%的患者在随访时有不良事件。随访时有不良事件的患者入院时IL-6和IL-10血清水平较高（分别为120±294 vs. 22±40 pg/ml，p<0.05；13±35 vs. 2±3 pg/ml，p=0.05）。IL-6和IL-10血清水平升高与随访时较高的不良事件发生率（对数秩检验p<0.001，<0.05，风险比分别为8.6、5.1）和死亡率（对数秩检验p<0.001，p<0.05，风险比分别为20.8、7.1）相关。与仅IL-6或IL-10水平升高或低于临界值的患者相比，IL-6和IL-10水平均升高的患者不良事件风险增加（任何事件的对数秩检验p<0.01，死亡的对数秩检验p<0.001；任何事件的风险比为1.20，死亡的风险比为1.31），即使在多变量Cox分析中校正年龄、左心室射血分数和NTproBNP水平后也是如此。
入院时血清IL-6和IL-10水平与随访期间较高的不良事件风险相关。
