Prognostic value of lactoferrin and cytokines in the assessment of adverse outcomes in patients with Q-wave myocardial infarction, died from acute heart failure
AbstractObjective. To study the changes of cytokines and acute phase proteins lactoferrin inflammation in patients who have died from the AHF to assess the unfavorable prognosis.
Material and methods. The study was conducted in cardiology Department # 1 of City clinical hospital, Novokuznetsk in the period from 2008 to 2013. Serum of 97 patients (58.5±1.06 years) with Q-wave uncomplicated complicated and large-focal myocardial infarction was examinated on the content of acute-phase protein-reactant: lactoferrin (lF) and proinflammatory cytokines interleukin (Il)-6, Il-8, tumor necrosis factor α (TNFa) and antiinflammatory cytokine Il-10. The concentration of lF and cytokines were determined using enzyme-linked immunosorbent assay using kits test systems Vector-best (Novosibirsk).
Result. Increasind of lF level 1.5 times with a probability of over 50% indicates the possibility of development of acute heart failure, and increasing by more than 2.1 times more likely than 80% indicate the risk of fatalities. A statistically significant increase of Il-6, Il-8, Il-10 and TNFa from deceased patients compared to survivors with uncomplicated myocardial infarction and the control group indicates more severe inflammatory process that occurs in the acute stage of myocardial infarction, which is an unfavorable prognostic criterion. The decrease in Il-8 and TNFa in cardiogenic shock from deceased patients is due to inhibition of immune processes in this condition.
Conclusion. The increased lF, Il-6, Il-8, Il-10 and FNOa levels at the died patients in the 1st days after hospitalization can serve in quality of additional diagnostic criteria of development of complications and risk of mortality for the patients who have arrived on hospitalization.
Keywords:myocardial infarction, acute-phase protein, lactoferrin, cytokines inflammation, cardiogenic shock, pulmonary edema