CLINICAL AND PREDICTIVE VALUE OF SERUM INTERLEUKINE-18 IN ST ELEVATION MYOCARDIAL INFARCTION

Aim. To assess clinical and predictive value of serum IL-18 in ST elevation myocardial infarction.

Material and methods. Totally, 132 patients included, hospitalized to Kemerovo cardiovascular dispensary due to STEMI with <24 hours pain onset. Assessment of IL-18 concentration (pg/ml) was done on 12th day of care.

Results. Mean concentration of IL-18 in all patients was 244,02 (172,13-315,91) pg/ml, that was 3,5 times higher than reference range. Correlation analysis showed relation of IL-18 levels with total cholesterol, with low density lipoproteides, left ventricle ejection fraction, glomerular filtration rate (GFR) by CKD-EPI: r=0,18 (р=0,040), r=0,24 (р=0,008), r=-0,19 (р=0,029), r=-0,18 (р=0,039), resp. Median concentration of IL-18 in multifocal atherosclerosis (MFA) patients was 214,75 (129,20-362,35) pg/ml vs. 140,40 (97,80-292,80) pg/ml in non-MFA patients (р=0,010). In those patients without any significant progression of BCA lesion, baseline concentration of IL-18 was 271,0 (128,3-358,4) mg/ml, but in patients with the increase of stenosis grade more than 30% and/or appearance of novel plaques the level of IL-18 was 119,35 (94,61-188,95) pg/ml.

Conclusion. In prediction of early (in-hospital) and long-term (3-year) stages of myocardial infarction there was no any clinical and predictive value of IL-18. Concentration of serum IL-18 did not relate to kidney diseases in STEMI patients, but correlates negatively with GFR defined by CKD-EPI. There was significant role of IL-18 in forming of multifocal atherosclerosis. High concentrations of IL-18 at 12th day of hospitalization were related to the increase of total cholesterol and LDL, and with the decrease of contractility of the left ventricle myocardium. In STEMI with MFA there is increase of IL-18 1,5 times. At the same time significant progression of atherosclerotic lesion during one year was found in patients with lower baseline IL-18 level, which requires further studies of the IL-18 role in atherogenesis

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